Polyarthritis and Massive Small Bowel Bleed: An Unusual Combination in Scrub Typhus

Iqbal, Nayyar; Titus, Solomon; Basheer, Aneesh; George, Sanjoy; Mookkappan, Sudhagar; Nair, Sreejayan; Ramdas, Anita; Sivakumar, Periyasamy; Anitha, Patricia; Kanungo, Reba

doi:10.21767/amj.2015.2299

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2021

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“…A robust literature review for scrub typhus with arthritis in children has yielded three case reports, of a 10-year-old girl from Northern India with ankle arthritis, 6 a 4-year-old boy from South India with hip arthritis, 7 and an adolescent male with massive small bowel haemorrhage and polyarthritis. 8 Our patient had arthritis in proximal interphalangeal and metacarpophalangeal joints with a typical eschar that was diagnostic of scrub typhus and scrub IgM ELISA confirmed this.…”

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confidence: 71%

Small joint polyarthritis – An unusual presentation of scrub typhus in a child

et al. 2021

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Scrub typhus is a common Rickettsial infection which is endemic in tropical regions. It is characterised by fever, eschar, thrombocytopenia, lymphadenopathy and organomegaly. Scrub typhus has significant morbidity and mortality owing to its multisystemic involvement. Non-inflammatory polyarthritis of small joints is an uncommon presentation in paediatric scrub typhus. We discuss a five-year-old boy who presented with fever, small joint polyarthritis, hepatosplenomegaly and pathognomonic eschar with positive scrub IgM ELISA. Arthritis resolved completely with doxycycline therapy without any deformity.

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Section: Discussionsupporting

confidence: 71%