Scrub Typhus Infection Precipitating Hemolysis in a Patient With G6PD Deficiency: A Case Report

Area of Science:

• Hematology
• Infectious Diseases
• Genetics

Background:

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common red blood cell enzymopathy.
• It is a known cause of intravascular hemolysis, particularly in response to oxidative stress.
• Scrub typhus is an infectious disease caused by Orientia tsutsugamushi.

Purpose of the Study:

• To report a case of a child with G6PD deficiency experiencing acute intravascular hemolysis due to scrub typhus.
• To highlight the potential for scrub typhus to trigger hemolysis in individuals with mild G6PD deficiency.
• To emphasize that normal G6PD levels during acute hemolysis do not rule out the deficiency.

Main Methods:

• Case report presentation.
• Clinical observation of a pediatric patient.
• Review of diagnostic criteria for G6PD deficiency and scrub typhus.

Main Results:

• The patient, diagnosed with G6PD deficiency, developed extensive intravascular hemolysis following scrub typhus infection.
• The severity of hemolysis occurred despite a seemingly mild G6PD deficiency.
• Initial G6PD enzyme assays during the acute hemolytic phase were within the normal range.

Conclusions:

• Scrub typhus infection is a significant trigger for acute, extensive intravascular hemolysis in patients with G6PD deficiency, even if considered mild.
• Diagnostic interpretation of G6PD levels requires careful consideration of the clinical context, as acute illness can mask underlying deficiency.
• Early recognition and management of both scrub typhus and G6PD deficiency are crucial in affected pediatric patients.