Abstract

Abstract Scrub typhus is a rickettsial disease transmitted to humans by arthropods, via the bite of larval mites (chiggers). A young man, aged 18 years admitted with the fever of 5 days and altered sensorium for 1 day. The patient was evaluated for tropical illness with encephalopathy and multiorgan dysfunction syndrome. Patient serology was positive for scrub typhus and fulfill requisite criteria (hemophagocytic lymphohistiocytosis [HLH]-2004) for secondary HLH. He was managed as scrub typhus with secondary HLH and was given dexamethasone 4 mg three times a day. Patient condition improved and discharged with normal vital.

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