A man who had been self-treating for high fever and fatigue for four days at home without improvement was eventually diagnosed with septic shock and multiple organ failure. He required dialysis, a ventilator, and intravenous broad-spectrum antibiotics but his condition did not improve. In critical condition, he was transferred to the 108 Central Military Hospital with circulatory collapse, myocarditis, progressive acute respiratory failure, acute liver and kidney damage, and thrombocytopenia.
Upon arrival at the hospital, doctors identified an ulcer on the patient’s right chest as typical of scrub typhus on July 2. Test results confirmed that the patient was infected with Orientia tsutsugamushi, the pathogen that causes scrub typhus. Following diagnosis, the patient was treated with specific antibiotics and supportive measures for organ failure. Currently, his fever has subsided, his breathing has improved, and his organ failure is showing signs of recovery.
Scrub typhus is an acute infectious disease transmitted through the bite of mite larvae that is caused by Orientia tsutsugamushi. Its diverse manifestations include prolonged high fever, severe headache, skin and mucous membrane congestion, and rash. Skin ulcers can form at the site of the larval bite in soft or moist skin areas such as fingers or hands. These ulcers initially present as blisters before progressing into oval shapes that become nodules with black scabs. They are usually painless and not itchy which makes them difficult for patients to notice especially in endemic areas where individuals should take precautions when staying or working in environments favored by scrub typhus larvae. Prompt medical attention is recommended for fevers of unknown origin accompanied by potential risk factors for scrub typhus.
