Scrub Typhus-Varied Presentation
Journal Title: Scholars Academic Journal of Pharmacy - Year 2016, Vol 5, Issue 2
Abstract
Scrub typhus is an acute febrile illness caused by mite-borne Gram-negative bacterium Orientia tsutsugamushi. We report a case of Multi organ dysfunction syndrome admitted in Intensive care unit and was diagnosed with Scrub Typhus. Patient was brought in a state of altered sensorium with profuse pink secretion from throat and gasping for breath. As GCS was 4 patient was intubated and kept under mechanical ventilation. History of Diabetes, Hypertension and Ischemic Heart disease from 5 years was noted. Patient had history of fever with chills, cough with expectoration and breathlessness for which she was admitted in local clinic which did not relieve her symptoms. Examination revealed hypotension, cyanosis, clubbing, pedal edema and tachycardia. Systemic examination revealed absent breath sounds in left hemithorax and right basal areas. Chest Radiography suggestive of alveolointerstitial infiltrates of left hemithorax and right lower zone. Arterial blood gas analysis showed acute type1 respiratory failure. Total count was 48,500/ mm3 and patient had abnormal renal function.Pao2/Fio2 was 180. Weil Felix test was positive with 1:320 dilutions on day 3 and Immunoflorescence assay was positive for IgM antibody. Patient responded to Doxycycline and improved over a period of 8 days. Scrub typhus should be considered as a possibility among patients admitted with Acute Respiratory distress syndrome (ARDS) which is often undiagnosed. Persistence of viable organisms should be evaluated as O. tsutsugamushi can cause chronic latent symptomatic infection in spite of antibiotic therapy. Keywords: Scrub Typhus, Multi organ Dysfunction syndrome, Septic shock, Acute Respiratory distress Syndrome.
Authors and Affiliations
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Mona Sepehrar, Hadi Khorram, Zahra Noroozpour
Keywords
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