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Acute pancreatitis due to scrub typhus.
[scrub typhus]
Scrub
typhus
is
endemic
in
large
parts
of
India
and
can
cause
multi-organ
failure
and
death
.
Acute
pancreatitis
as
a
complication
is
very
rare
and
is
potentially
fatal
.
This
case
series
describes
seven
adult
patients
who
presented
with
an
acute
febrile
illness
and
were
diagnosed
to
have
scrub
typhus
with
acute
pancreatitis
.
The
mean
age
of
the
seven
patients
with
acute
pancreatitis
was
49
.
4
years
,
and
mean
duration
of
fever
prior
to
presentation
was
7
.
7
days
.
All
seven
patients
had
abdominal
pain
,
and
three
had
a
pathognomonic
eschar
.
The
mean
serum
lipase
level
was
1
,
509
U
/
L
(
normal
value
:
<
190
U
/
L
)
and
the
mean
serum
amylase
level
was
434
U
/
L
(
normal
value
:
<
200
U
/
L
)
.
Six
patients
had
evidence
of
multi-organ
dysfunction
.
Hematological
and
respiratory
system
dysfunction
was
seen
in
five
patients
,
hepatic
and
renal
dysfunction
in
four
,
and
central
nervous
system
dysfunction
in
three
patients
.
Three
patients
who
had
≥
4
organs
involved
,
died
(
mortality
rate
:
42
.
8
%
)
.
Our
case
series
shows
that
pancreatitis
in
scrub
typhus
is
an
extremely
rare
complication
and
when
present
,
is
associated
with
increased
mortality
(
42
.
8
%
)
.
Physicians
may
be
familiar
with
the
various
complications
of
scrub
typhus
but
less
so
with
acute
pancreatitis
and
hence
may
be
underdiagnosed
.
Diseases
Validation
Diseases presenting
"renal dysfunction"
symptom
cushing syndrome
fabry disease
familial mediterranean fever
homocystinuria without methylmalonic aciduria
legionellosis
scrub typhus
severe combined immunodeficiency
systemic capillary leak syndrome
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