A Case Report of an Unusual Presentation: Could the Early Use of Interventional Radiology have Saved this Patient of Scrub Typhus

Karim, Habib Md Reazaul; Bhattacharyya, Prithwis; Yunus, Muhammad

doi:10.3329/bccj.v2i2.24086

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…However, unusual presentations of these diseases are not so uncommon. 3 , 7 , 8 Both these diseases are notorious for their contributions to multiple organ involvement.…”

Section: Discussionmentioning

confidence: 99%

Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient

Karim

Bhattacharyya

Kakati

et al. 2016

Qatar Medical Journal

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Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without fever, dehydration, hemorrhage and hemolysis may lead to low blood pressure. Presence of toxic granules and elevated band forms in such patients can even mimic sepsis. When such a patient is in the peripartum period, it creates a strong clinical dilemma for the physician especially in unbooked obstetric cases. We present such a case where a 26-year-old unbooked female presented on second postpartum day with severe anemia, altered sensorium, difficulty in breathing along with jaundice and gum bleeding without history of fever. Rapid diagnostic test for malaria was negative and no eschar was seen. These parameters suggested a diagnosis of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet) syndrome with or without puerperal sepsis. Subsequently she was diagnosed as having asymptomatic malaria and scrub typhus and responded to the treatment of it. The biochemical changes suggestive of HELLP syndrome also subsided. We present this case to emphasize the fact that mere absence of fever and eschar does not rule out scrub typhus. It should also be considered as a differential diagnosis in patients with symptoms and signs suggesting HELLP syndrome. Asymptomatic malaria can complicate case scenario towards puerperal sepsis by giving false toxic granules and band form in such situations.

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“…However, unusual presentations of these diseases are not so uncommon. 3 , 7 , 8 Both these diseases are notorious for their contributions to multiple organ involvement.…”

Section: Discussionmentioning

confidence: 99%

Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient

Karim

Bhattacharyya

Kakati

et al. 2016

Qatar Medical Journal

Self Cite

View full text Add to dashboard Cite

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Scrub typhus in Northeast India: epidemiology, clinical presentations, and diagnostic approaches

Konyak,

Soni,

Saikia

et al. 2023

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Scrub typhus is one of the most neglected tropical diseases, a leading cause of acute undifferentiated febrile illness in areas of the ‘tsutsugamushi triangle’, diagnosed frequently in South Asian countries. The bacteria Orientia tsutsugamushi is the causative agent of the disease, which enters the human body through the bite of trombiculid mites (also known as chiggers) of the genus Leptotrombidium deliense. Diagnosis of the disease is challenging, as its early symptoms mimic other febrile illnesses like dengue, influenza and corona viruses. Lack of rapid, reliable and cost-effective diagnostic methods further complicates the identification process. Northeast India, a mountainous region with a predominantly rural tribal population, has witnessed a resurgence of scrub typhus cases in recent years. Various ecological factors, including rodent populations, habitat characteristics and climatic conditions, influence its prevalence. Entomological investigations have confirmed the abundance of vector mites, highlighting the importance of understanding their distribution and the probability of transmission of scrub typhus in the region. Proper diagnosis, awareness campaigns and behavioural interventions are essential for controlling scrub typhus outbreaks and reducing its impact on public health in Northeast India. Further research and community-based studies are necessary to accurately assess the disease burden and implement effective prevention strategies.

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A Case Report of an Unusual Presentation: Could the Early Use of Interventional Radiology have Saved this Patient of Scrub Typhus

Abstract: A 19-year-old soldier was referred to our Intensive Care Unit (ICU) with a diagnosis of pyrexia of unknown origin in a state of deep coma (GCS 6/15)

Cited by 2 publications

References 8 publications

Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient

Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient

Scrub typhus in Northeast India: epidemiology, clinical presentations, and diagnostic approaches

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