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Case Report: Acute pyelonephritis and hearing loss in scrub typhus
Sivaranjini Venketesan1, Dheeraj Jain1, Stalin Viswanathan2
1Department of General Medicine, Indira Gandhi Medical College & Research Institute, Pondicherry, Puducherry, 605009, India.
F1000Research
|July 25, 2019
Summary
Scrub typhus can mimic acute pyelonephritis in diabetic patients, leading to delayed diagnosis. Early consideration of systemic infections like rickettsioses is crucial for effective treatment in diabetic individuals.
Area of Science:
- Infectious Diseases
- Nephrology
- Internal Medicine
Background:
- Acute pyelonephritis is a frequent renal complication in diabetic patients.
- Prompt diagnosis and treatment are essential to prevent complications.
Observation:
- A 52-year-old diabetic woman presented with symptoms suggestive of pyelonephritis, including loin pain, dysuria, and fever.
- Despite broad-spectrum intravenous antibiotics, her condition did not improve, and cultures were sterile.
- Mild hepatic dysfunction raised suspicion for an alternative diagnosis.
Findings:
- The patient improved with empirical doxycycline treatment.
- Serological tests confirmed Scrub Typhus (a type of rickettsiosis).
- This case represents acute pyelonephritis caused by scrub typhus, previously undescribed in English literature.
Implications:
- Diabetic patients with fever and urinary symptoms should be evaluated for systemic infections like rickettsioses.
- Considering local rickettsial prevalence can aid in diagnosing atypical presentations of common infections.
- This highlights the importance of a broad differential diagnosis in complex cases.
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