A Case Series of Scrub Typhus from Eastern State of India

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A Case Series of Scrub Typhus from Eastern State of India

1Dr. Jemima Islam, 2Dr. Md. Karimulla Mondal, 3Dr. Sumit Kumar Ghosh, 4Prof. Dr. Soumitra Ghosh
1Junior Resident, Department of Internal Medicine, IPGMER & SSKM Hospital, Kolkata – 700020, India
2Senior Resident, Department of Internal Medicine, IPGMER & SSKM Hospital, Kolkata – 700020, India
3Assistant professor, Department of Internal Medicine, IPGMER & SSKM Hospital, Kolkata – 700020, India
4Professor, Department of Internal Medicine, IPGMER & SSKM Hospital, Kolkata – 700020, India
Corresponding author: Dr. Jemima Islam


ABSTRACT:
Scrub typhus is one of the endemic diseases leading to acute febrile illness in the topical countries. It can present with its various manifestations ranging from asymptomatic illness to serious multiorgan dysfunctions. The most common pathophysiology behind this multisystem manifestation is the systemic vasculitis due to exaggerated immune response. Early diagnosis and aggressive treatment along with close monitoring of vitals with best supportive measures may be the satisfactory response to the physician. Here, in this case series we are discussing five cases of scrub typhus presented with various atypical and uncommon manifestation HLH (Case 1), Encephalopathy, Pancytopenia, AKI, Intrahepatic cholestasis, Pancreatitis (Case 2), meningoencephalitis (Case 3), myocarditis (Case 4) and Leukemoid reaction, ALF (Case 5).  
KEYWORDS:
Scrub typhus, Leukemoid reaction, meningoencephalitis, Intrahepatic cholestasis, Pancreatitis, myocarditis, Hemophagocytic Lymphohistiocytosis.  
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