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Multiple eschars in scrub typhus: a case report
Munegowda Koraluru1, Manideep Nandigam2, Indira Bairy3
1Lecturer, Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Tropical Doctor
|July 15, 2016
Summary
Multiple eschars, a rare sign of scrub typhus, aid in early diagnosis and treatment. This case highlights the importance of searching for multiple eschars in febrile patients, especially in new endemic areas.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Dermatology
Background:
- Scrub typhus diagnosis relies on eschar identification, but positivity rates vary.
- Multiple eschars are an uncommon presentation of scrub typhus.
Observation:
- A patient presented with fever and multiple eschars.
- The patient was empirically treated with doxycycline.
Findings:
- Nested PCR confirmed Orientia tsutsugamushi in all four eschars and blood.
- The 56-kDa type-specific antigen was detected, confirming scrub typhus.
Implications:
- Multiple eschars are a significant diagnostic clue for scrub typhus.
- Clinicians should actively search for multiple eschars in febrile patients.
- Early diagnosis and treatment with doxycycline led to complete recovery.
