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Case Report
Online Published: 27 Dec 2024
 


Atypical presentation and response to treatment in scrub typhus: a series of 2 cases

Deepshikha Singh, Shivangi Singh, Sanjay Kumar Tanti, Diwakar Kumar.


Abstract
Scrub typhus is an acute febrile illness caused by Orientia Tsutsugamushi. It usually presents with high fever, lymphadenopathy, rash, organomegaly, and an eschar formation at the site of bite. Doxycycline is the drug of choice usually showing rapid defervescence, but rarely some cases do not respond. Here we present 2 such cases which did not respond to Doxycycline and had atypical presentation. Our first case presented with fever for 15 days and then went into shock and multiorgan dysfunction despite having no fever after admission. Our second case presented in status epilepticus and septic shock. He developed purpura fulminans even after starting treatment. Both the cases did not respond to Doxycycline. Diagnosis was confirmed by Scrub Typhus IgM Antibody positivity. They were successfully treated with second line drugs i.e. Azithromycin and Chloramphenicol.

Key words: Scrub typhus, Doxycycline resistance, Purpura Fulminans, Acute undifferentiated febrile illness.


 
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How to Cite this Article
Pubmed Style

Singh D, Singh S, Tanti SK, Kumar D. Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudan J Paed. 2024; 24(2): 170-174. doi:10.24911/SJP.106-1717484863

Web Style

Singh D, Singh S, Tanti SK, Kumar D. Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. https://sudanjp.com//?mno=204331 [Access: June 27, 2026]. doi:10.24911/SJP.106-1717484863

AMA (American Medical Association) Style

Singh D, Singh S, Tanti SK, Kumar D. Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudan J Paed. 2024; 24(2): 170-174. doi:10.24911/SJP.106-1717484863


Vancouver/ICMJE Style

Singh D, Singh S, Tanti SK, Kumar D. Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudan J Paed. (2024), [cited June 27, 2026]; 24(2): 170-174. doi:10.24911/SJP.106-1717484863


Harvard Style

Singh, D., Singh, . S., Tanti, . S. K. & Kumar, . D. (2024) Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudan J Paed, 24 (2), 170-174. doi:10.24911/SJP.106-1717484863


Turabian Style

Singh, Deepshikha, Shivangi Singh, Sanjay Kumar Tanti, and Diwakar Kumar. 2024. Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudanese Journal of Paediatrics, 24 (2), 170-174. doi:10.24911/SJP.106-1717484863


Chicago Style

Singh, Deepshikha, Shivangi Singh, Sanjay Kumar Tanti, and Diwakar Kumar. "Atypical presentation and response to treatment in scrub typhus: a series of 2 cases." Sudanese Journal of Paediatrics 24 (2024), 170-174. doi:10.24911/SJP.106-1717484863


MLA (The Modern Language Association) Style

Singh, Deepshikha, Shivangi Singh, Sanjay Kumar Tanti, and Diwakar Kumar. "Atypical presentation and response to treatment in scrub typhus: a series of 2 cases." Sudanese Journal of Paediatrics 24.2 (2024), 170-174. Print. doi:10.24911/SJP.106-1717484863


APA (American Psychological Association) Style

Singh, D., Singh, . S., Tanti, . S. K. & Kumar, . D. (2024) Atypical presentation and response to treatment in scrub typhus: a series of 2 cases. Sudanese Journal of Paediatrics, 24 (2), 170-174. doi:10.24911/SJP.106-1717484863




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