Scrub Typhus as Differential Diagnosis of Covid-19 in Present Scenario : A Case Report

Abstract

Scrub typhus is a rickettsial disease predominantly seen in Asian pacic region. It is caused by pathogen Orientia tsutsugamushi. Vector involved in scrub typhus is larval trombiculid mite(chigger). It presents as acute febrile illness with cough, severe headache and myalgia. Complications include pneumonitis, acute respiratory distress syndrome, myocarditis, meningitis etc. Eschar or rash may not be present. Severity of illness can range from mild symptoms to multi-organ failure and death. We report a case of scrub typhus who presented with fever, shortness of breath and low oxygen saturation in emergency. Patient is a middle aged female with no known co-morbidities. Initially she was kept in COVID-19 suspected ICU and was managed supportively. HRCT was suggestive of Acute Respiratory Distress Syndrome (ARDS). RT-PCR for SAR-CoV2 came out negative. On evaluation it was found that she was having scrub typhus. In present scenario, not all patients who are having symptoms of fever, shortness of breath can be COVID19, scrub typhus is one of those illnesses which may present similar to COVID19. Early diagnosis and prompt treatment of scrub typhus is essential as any delay might lead to dreadful complication and can be fatal.