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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
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated
