SCRUB TYPHUS AS MISSED DIAGNOSIS FOR ACUTE FEBRILE ILLNESS IN MALAYSIA, SOUTHEAST ASIA

ELTANAHY, MOHAMED ABD ELWAHAB; SHAH, KHAISRO ALI; ROUEE, ALCAN TAN; YIH, TEE HANN; HUI, CHEK XIAO; LING, TAN JIA; TUIYOTT, MONA CHEPKOECH; RAJANDRAM, KEERAN A/L; WEI, CHENG JUNN; QUINN, SILVIA TEOW SU; RASHAD, MOHAMED MAHMOUD; YUE, ONG QI; ELHARIRI, SHERREEN Y. Z.

doi:10.21608/jesp.2024.373523

SCRUB TYPHUS AS MISSED DIAGNOSIS FOR ACUTE FEBRILE ILLNESS IN MALAYSIA, SOUTHEAST ASIA

Authors

¹ Department of Paediatrics, School of Medicine, International Medical University (IMU) Clinical Campus, Batu Pahat

² Medical Graduated, International Medical University (IMU)

³ Department of Surgery, School of Medicine, (IMU) Clinical Campus, Seremban, Malaysia

10.21608/jesp.2024.373523

Abstract

Scrub typhus (Tsutsugamushi fever) is caused by Orientia tsutsugamushi (previous Rickettsia)
and is transmitted to man by a mite vector of the Trombiculidae family (Leptotrombidium
deliense and L. akamushi). Scrub typhus was confined geographically to the Asia Pacific region,
but now distributed in the tsutsugamushi triangle.
The patient usually presents with Eschar, a vesicular lesion at mite feeding site. Other complications
are fever, maculopapular rash on trunk, and spreading to limbs. Serious one in the form
of myocarditis, pneumonia, meningoencephalitis, jaundice acute renal failure, gastrointestinal
bleeding, and even acute respiratory distress syndrome may develop.
The fever and eschar supported the diagnosis, which was confirmed serological by Scrub Typus
IgM antibodies. The patient was improved by doxycycline injections. Doctors must be aware of
zoonotic bacterial infections, which are easily treatable on early diagnosing.

Keywords