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Scrub typhus complicated by acute respiratory distress syndrome and multiorgan failure; an unrecognized alarming entity in central India: a report of two cases.
[scrub typhus]
Scrub
typhus
is
an
acute
infectious
illness
,
distributed
throughout
the
Asia
Pacific
rim
.
In
India
,
it
has
been
reported
from
northern
,
eastern
,
and
southern
India
.
However
,
cases
of
scrub
typhus
have
not
been
well-documented
from
Vidarbha
,
an
eastern
region
of
Maharashtra
state
in
central
India
.
We
report
two
cases
of
complicated
scrub
typhus
from
Vidarbha
region
.
These
cases
admitted
in
unconscious
state
with
8
-
10
days
history
of
fever
,
body
ache
,
cough
,
and
progressive
breathlessness
.
The
diagnosis
in
both
cases
was
based
on
presence
of
eschar
,
a
positive
Weil-
Felix
test
,
and
a
positive
rapid
diagnostic
test
(
immunochromatographic
assay
)
.
Both
cases
were
complicated
by
acute
respiratory
distress
syndrome
(
ARDS
)
and
multiorgan
failure
.
Both
of
them
presented
in
their
2
(
nd
)
week
of
illness
and
died
during
the
hospital
course
in
spite
of
intensive
supportive
care
.
The
main
cause
of
mortality
was
delayed
referral
leading
to
delay
in
diagnosis
and
treatment
.
Diseases
Validation
Diseases presenting
"respiratory distress"
symptom
cohen syndrome
congenital diaphragmatic hernia
cutaneous mastocytosis
dentinogenesis imperfecta
erdheim-chester disease
familial hypocalciuric hypercalcemia
harlequin ichthyosis
heparin-induced thrombocytopenia
junctional epidermolysis bullosa
legionellosis
locked-in syndrome
neuralgic amyotrophy
scrub typhus
systemic capillary leak syndrome
typhoid
This symptom has already been validated