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Scrub Typhus with Sepsis and Acute Respiratory Distress Syndrome |
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| Authors: | Asok Kurup Aneesh Issac Jin Phang Loh Too Bou Lee Robert Chua Pradeep Bist Chien-Chung Chao Michael Lewis Duane J. Gubler Wei Mei Ching Eng Eong Ooi Bindu Sukumaran |
| Affiliation: | Mount Elizabeth Hospital, Singaporea;Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singaporeb;DSO National Laboratories, Singaporec;Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland, USAd;Henry M. Jackson Foundation, Bethesda, Maryland, USAe |
| Abstract: | Scrub typhus is a major infectious threat in the Asia-Pacific region. We report an unusual case of scrub typhus in a patient in Singapore who presented with sepsis and acute respiratory distress syndrome but lacked the pathognomonic eschar. The patient recovered after appropriate diagnosis and doxycycline treatment. Rickettsial diseases should be included in the differential diagnosis of febrile illnesses in regions where the diseases are endemic, and absence of eschar should not be the criterion used to rule out scrub typhus. |
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