| Autor: |
Ravikumar DB; Department of Internal Medicine, ESIC Medical College and PGIMSR, Chennai, India., Sivasubramanian BP; Department of Infectious Diseases, University of Texas Health Science Centre, San Antonio, USA., Shanmugam SN; Department of Internal Medicine, Kasturba medical college, Mangalore, India., Krishnaswamy V; Department of Pediatrics, KAPV Government Medical College, Trichy, India., Rabaan A; Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.; Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan., Al-Tawfiq JA; Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.; Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.; Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA., Tirupathi R; Cure Drug Repurposing Collaboratory. |
| Abstrakt: |
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi , a Gram-negative bacillus, commonly occurring in the Asia-Pacific region. It is transmitted to humans by the bite of an infected Leptotrombidium mite and the bacterium causes endothelial dysfunction resulting in widespread vasculitis and the possible development of thrombocytopenia, meningitis, acute respiratory distress syndrome, and infrequently, myocarditis. Early diagnosis and prompt treatment are crucial in managing scrub typhus. Here, we present four cases of scrub typhus with a comprehensive literature review. This study highlights the significance of considering scrub typhus as a possible diagnosis in patients of all ages from endemic regions who exhibit symptoms such as fever, thrombocytopenia, or transaminitis, even in the absence of typical clinical features. Two cases exhibited the characteristic lesion of eschar at the site of mite feeding. One case involved a middle-aged woman who was diagnosed with typhus-induced myocarditis with left ventricular dysfunction. Another case involved a 23-day-old neonate with poor feeding and seizures, who was diagnosed with late-onset sepsis with meningitis. Scrub typhus was confirmed in all cases using a positive qualitative IgM ELISA. However, it is preferred to use paired (ELISA before and after antibiotic therapy) or quantitative titers for confirmation. Healthcare providers must consider the patient's exposure history and clinical presentation to diagnose and treat scrub typhus promptly. |
