A Rare Presentation of Scrub Typhus: Multi-Organ Dysfunction [Acute Kidney Injury, Hepatitis] and Acute Respiratory Distress Syndrome

Abstract

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi- a gram negative intracellular bacilli. It typically manifests as eschar formation, fever, rash, myalgia and diffuse lymphadenopathy. The clinical severity of scrub typhus ranges from mild fever to a lethal outcome. Complications like sepsis, acute respiratory distress syndrome (ARDS) and multi organ dysfunction syndrome (MODS)--hepatitis, acute kidney injury contribute to the higher mortality rates, which range from 7-30% in untreated cases. Here, we report a case of 35 years old male who presented with complaints of fever, headache, generalised abdominal pain and dry cough for 7 days. The patient was tested positive for Scrub Typhus IgM antibody; and was complicated with MODS- AKI, Hepatitis and ARDS. After extensive intensive care, monitoring and treatment of 15-20 days, the patient recovered. Hence, early diagnosis and prompt treatment aids in decreasing the mortality in such cases.