Three cases of scrub typhus with hemorrhage: a case report and literature review

Abstract

Scrub typhus (ST) is an acute focal infectious disease that is caused by Orientia tsutsugamushi. The Asia-Pacific region is an area of relatively high incidence. There is a high incidence in China, principally owing to the disease being endemic in the south of the country. The main source of ST infection is rats, which act as reservoirs of infection after being bitten by the chigger mite, and the human population is generally susceptible to the disease. ST can be controlled and treated successfully if antibiotics are administered in a timely manner. However, because it does not have a specific clinical manifestation, it is difficult to distinguish ST from other febrile diseases in clinical practice. Therefore, rapid diagnostic methods are still needed to help clinicians make a timely diagnosis. Here, we share three cases of patients with ST who experienced hemorrhage, but did not have typical skin lesions, such as eschar and ulcer, early in the course of their disease, and review the relevant literature regarding ST. We conclude that clinicians should pay attention to the risk of hemorrhage associated with this disease, and emphasize the importance of making an early diagnosis.

A case of scrub typhus with meningitis as the onset: Case report and literature review

“…Studies have shown that scrub typhus often leads to multisystem dysfunction in the second week of onset, manifested as myocardial injury, interstitial pneumonia, meningitis or meningoencephalitis, pancreatitis, abnormal liver function, acute kidney injury, and optic neuritis. [ 6 ] It was uncommon for this patient to manifest symptoms and signs of central nervous system infection from the beginning. This case report aims to guide clinicians in the diagnosis and treatment of scrub typhus with central nervous system involvement as the first symptom.…”