scholarly journals A case of scrub typhus presenting as ARDS

2019 ◽  
Vol 10 (3) ◽  
pp. 2014-2016
Author(s):  
Ahmed Siddique A ◽  
Jagadeesan M ◽  
Mariraj I ◽  
Ramkumar M ◽  
Prasanna Karthik S1 ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Central Nervous System Involvement ◽  
Febrile Illness ◽  
Interesting Case ◽  
Systemic Spread

Acute respiratory distress syndrome (ARDS) is a disease, mainly occurring in critically ill patients. The systemic spread of infections mainly causes ARDS due to the seepage of fluid in the spaces of the lung . Scrub typhus is a infection caused by . The bite of mite transmits it. Scrub typhus is frequently due to its non-specific clinical presentation and relatively low level of suspicion in treating physicians. The clinical presentation of scrub typhus is varied from fever, , rashes, headache, to pneumonia, acute respiratory distress syndrome, sepsis, central nervous system involvement. The disease is usually indistinguishable from other febrile illness like enteric fever, disease, malaria and certain viral hemorrhagic fevers. Identification of an points to the diagnosis without which the diagnosis is based on a high index of clinical suspicion. We report an interesting case of scrub typhus presenting as acute respiratory distress syndrome.

Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome

2021 ◽  
Vol 14 (4) ◽  
pp. e242870
Author(s):  
Meenupriya Arasu ◽  
Nagalakshmi Swaminathan ◽  
Anusha Cherian ◽  
Magesh Parthiban
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Pregnant Patient ◽  
Lung Compliance ◽  
Pcr Assay ◽  
Oxygenation Indices

A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.

scholarly journals Risk factors of acute respiratory distress syndrome in Scrub typhus

2017 ◽  
Vol 5 (9) ◽  
pp. 3912 ◽  
Author(s):  
Karunya Jayasimha ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Indira Bairy ◽  
Rahul Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
High Mortality ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Early Recognition ◽  
Febrile Illness

Background: Scrub typhus is a common tropical infection presenting as acute febrile illness. Acute Respiratory Distress Syndrome (ARDS) is a serious complication of scrub typhus and is often associated with high mortality. This study was aimed to analyse risk factors of ARDS in Scrub typhus patients.Methods: This study was a prospective observational case control study conducted from June 2012 to June 2015 in Kasturba Hospital, Manipal, Karnataka, India. ARDS was diagnosed as per Berlin criteria.Results: During the study period, a total of 320 patients were diagnosed to have scrub typhus as per our criteria. All the patients were from state of Karnataka except for 1 patient, who was from state of Kerala. A total of 20 (6.25%) patients (cases) were diagnosed to have ARDS and 300 (93.75%) patients (controls) did not have ARDS. After multivariate analysis of the risk factors only two risk factors had significant association with development of ARDS: sepsis (OR 4.34,95% CI 0.51,36.76) and septic shock (OR 16.57 95% CI 1.64,166.76).Conclusions: ARDS is a common and serious complication of scrub typhus. It often occurs along with other complications. Presence of dyspnoea, sepsis, septic shock, hypoalbuminemia should alert clinicians about ARDS. ARDS due to scrub typhus is associated with high mortality. Early recognition and prompt therapy can reduce mortality.

scholarly journals Afebrile Scrub Typhus (Tsutsugamushi disease) with Acute Respiratory Distress Syndrome.

2002 ◽  
Vol 41 (8) ◽  
pp. 667-670 ◽  
Author(s):  
Koichi ICHIMURA ◽  
Yoshiko UCHIDA ◽  
Kunihiko ARAI ◽  
Kenji NAKAZAWA ◽  
Junichi SASAKI ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Tsutsugamushi Disease

scholarly journals Clinical and demographic study of scrub typhus in a tertiary care teaching hospital in Puducherry during 2015-2018

2018 ◽  
Vol 6 (11) ◽  
pp. 3534
Author(s):  
I. Sariga ◽  
S. S. Karthik ◽  
P. Vivian Joseph Ratnam
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Teaching Hospital ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Demographic Profiles

Background: Scrub typhus is a vector borne rickettsial disease commonly found in many parts of India. Scrub typhus can frequently cause complications like pneumonia, acute respiratory distress syndrome (ARDS) and has a mortality rate of 30 to 45% in untreated cases. Diagnosis of scrub typhus is difficult, with serum IgM capture ELISA being the most sensitive test. Present study objectives were to study the clinical and demographic profiles of scrub typhus cases in a tertiary care teaching hospital in the Union Territory of Puducherry, India.Methods: A descriptive study was carried out to analyze clinical and demographic profiles of patients who were positive for IgM antibodies against Orientia tsutsugamushi by scrub typhus IgM ELISA during a three year period (April 2015 to March 2018). Demographic details like age and sex of the patients, clinical signs, symptoms and complication if any were analyzed.Results: A total of 428 patients were found to have been diagnosed with scrub typhus during the study period. Among them, 46% were males and 54% were females. Among all the positive cases, 23.5% were paediatric cases, the second highest group was the 31 to 40 years age group (17.7%). Thirteen percent of positive cases were above 60 years of age. Fever was the most common symptom (92.9%) and eschar was found in 22.9% of patients. The most common complication found in the patients with scrub typhus was acute respiratory distress syndrome (15.9%). Other complications like hepatic dysfunction, pleural effusion and meningoencephalitis were noted.Conclusions: Adequate knowledge about scrub typhus helps in early diagnosis, which facilitates early appropriate antibiotic and supportive therapy, which helps in the recovery of the patient without acquiring complications.

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