Internal Medicine, Midnapore Medical College and Hospital, Midnapore, West Bengal, India.
Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
BMJ Case Rep. 2024 Jul 2;17(7):e261003. doi: 10.1136/bcr-2024-261003.
Scrub typhus, a prevalent tropical infection, may sometimes manifest with unusual complications. Here, we present the case of a young man who was admitted to our facility with a fever for the past 3 days and passage of dark-coloured urine since that morning. On investigation, we identified intravascular haemolytic anaemia. Through meticulous examination, a black necrotic lesion (eschar) was discovered on his right buttock, a pathognomonic sign of scrub typhus infection. Treatment was initiated with oral doxycycline 100 mg two times a day. Subsequently, diagnosis of scrub typhus was confirmed through positive results from scrub typhus IgM via ELISA and PCR analysis from the eschar tissue. The patient responded well to oral doxycycline and his symptoms resolved within the next few days. This case highlights severe intravascular haemolysis associated with scrub typhus infection.
恙虫病是一种流行的热带感染病，有时可能表现出不寻常的并发症。在这里，我们介绍了一个年轻人的病例，他因发热入院，症状已持续 3 天，今早开始出现深色尿液。经过调查，我们发现他患有血管内溶血性贫血。通过仔细检查，在他的右臀部发现了一个黑色坏死性病变（焦痂），这是恙虫病感染的特征性标志。我们开始用口服强力霉素 100mg，每日两次进行治疗。随后，通过 ELISA 检测恙虫病 IgM 呈阳性以及从焦痂组织进行 PCR 分析，确诊为恙虫病。患者对口服强力霉素反应良好，他的症状在接下来的几天内得到缓解。本病例强调了与恙虫病感染相关的严重血管内溶血。
