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Skin Diseases and Disorders01:23

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Cellulitis that was NOT Cellulitis.

Aditi D Punwani1, Keyur K Dave2, Yuti Sheth3

  • 1Consultant, Department of Pulmonology, Bharatiya Arogya Nidhi Hospital, Mumbai, Maharashtra, India, Corresponding Author.

The Journal of the Association of Physicians of India
|March 15, 2025
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Summary
This summary is machine-generated.

This case highlights scrub typhus, an infectious disease, presenting atypically as cellulitis in a traveler. Early diagnosis and doxycycline treatment are crucial for recovery and preventing complications.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Tropical Medicine

Background:

  • Cellulitis is a common bacterial skin infection, frequently affecting lower limbs.
  • Atypical presentations can obscure diagnosis, necessitating broader differential considerations.
  • Travel history is a critical factor in diagnosing febrile illnesses in endemic regions.

Purpose of the Study:

  • To report a case of scrub typhus presenting as severe cellulitis with systemic involvement.
  • To emphasize the importance of considering tropical zoonotic diseases in travelers with unexplained febrile illnesses.
  • To highlight the diagnostic utility of the Weil-Felix test and response to doxycycline.

Main Methods:

  • Case report of a male patient with extensive travel history.
  • Clinical presentation of left lower limb cellulitis, hyperbilirubinemia, and acute kidney injury.
  • Diagnostic workup including Weil-Felix test and empirical treatment with doxycycline.

Main Results:

  • The patient presented with symptoms mimicking common cellulitis but with unusual systemic findings.
  • The Weil-Felix test was positive, indicating scrub typhus infection.
  • Prompt treatment with doxycycline led to a significant improvement in the patient's condition.

Conclusions:

  • Scrub typhus should be suspected in travelers presenting with febrile illness, even with atypical dermatological manifestations like cellulitis.
  • Timely diagnosis and treatment with doxycycline are essential to prevent severe complications and ensure patient recovery.
  • Integrating travel history into the diagnostic process is vital for identifying and managing uncommon tropical infections.