Delayed diagnosis of Scrub Typhus in Dengue epidemic: A Case Report

Pratap Singh, Sanjay Kumar, Subodh Kumar Mahto, Ramesh Chand Meena


We report a case of scrub typhus presenting with fever and thrombocytopenia highlighting the wide variation in clinical presentations leading to delayed diagnosis in dengue epidemic. Fever and thrombocytopenia are the most common clinical presentation in viral haemorrhagic fever but others diseases like malaria, typhoid, leptospira, rickettsial and other arboviral diseases, should also be considered in the differential diagnosis. A high clinical suspicion of scrub typhus and early differentiation from other diseases is important as lethal complications can occur because of delay in diagnosis and treatment.


Scrub typhus, Dengue, Thrombocytopenia

Full Text:



Vivekanandan M, Mani A, Priya YS et al. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India 2010; 58: 24-28. 2. Mathai E, Rolain JM, Verghese GM et al. Outbreak of scrub typhus in southern India during the cooler months. Ann NY Acad Sci 2003; 990: 359-64. 3. Choi YH, Kim SJ, Lee JY et al. Scrub typhus: Radiological and clinical findings. Clin Radiol 2000; 55: 140-44. 4. Mahajan SK. Scrub typhus. J Assoc Physicians India 2005; 53: 954-58. 5. Watt G. Scrub typhus. In: Warrell DA, Cox TM, Firth JD et al. (Eds.). Oxford Text Book of Medicine. 4th Edn. Oxford: Oxford University Press, 2003: 629-31. 6. Hechemy KE, Stevens RW, Sasowski S et al. Discrepancies in Weil Felix tests and microimmunofluorescence test results in Rocky Mountain Spotted fever. J Clin Microbiol Feb 1979; 9(2): 292-93. 7. Koh GC, Maude RJ, Paris DH et al. Diagnosis of scrub typhus. Am J Trop Med Hyg 2010; 82: 368-70. 8. Sonthayanon P, Chierakul W, Wuthiekanun V et al. Association of high Orientia tsutsugamushi DNA loads with disease of greater severity in adults with scrub typhus. J Clin Microbiol 2009; 47: 430-34. 9. Poomalar GK, Rekha R. Scrub typhus in pregnancy. Journal of Clinical and Diagnostic Research Dec 2014; 8(12): 1-3.


  • There are currently no refbacks.

Copyright (c) 2016 Journal of Advanced Research in Medicine