Scrub typhus masquerading as puerperal sepsis
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240494Keywords:
Scrub typhus, Puerperal fever, Puerperal sepsis, Acute undifferentiated febrile illnessAbstract
Scrub typhus is a zoonotically transmitted febrile illness caused by Orientia tsutsugamushi and transmitted by the larval stage of the leptotrombiculid mite. It is the most common rickettsial illness worldwide and has re-emerged as a major cause of Acute Undiffrentiated Febrile Illness (AUFI). It has a varied presentation ranging from a mild self-limiting illness to a life threatening condition with multi organ failure in 35 to 50% cases. Acute onset fever with pain abdomen, rashes, lymphadenopathy and eschars are the usual manifestations. The presentation, however, may be varied in pregnancy and the postpartum period due to altered immunological response of the body. A 33 year old lady presented on day 13 post-partum with high grade fever and hypotensive shock. An initial diagnosis of puerperal sepsis was made and empirical antibiotics started. Due to persistent high grade fever, with fluid refractory hypotension, a complete septic work up including Scrub typhus serology was sent which was found to be positive. Injection doxycycline was added to the treatment regimen following which the fever and rashes subsided and general condition improved.
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References
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