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Scrub Typhus-Associated Acute Pancreatitis: A Comprehensive Review and New Case Series
1Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
The American Journal of Tropical Medicine and Hygiene
|November 4, 2025
Summary
Scrub typhus can cause acute pancreatitis, a severe complication. Early recognition and treatment are crucial, especially when multiple organ dysfunction syndrome develops, to improve patient survival.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Critical Care Medicine
Background:
- Scrub typhus, caused by Orientia tsutsugamushi, is a prevalent vector-borne illness in Asia.
- Acute pancreatitis is a rare but severe complication of scrub typhus.
- This complication can lead to significant morbidity and mortality.
Purpose of the Study:
- To systematically review and analyze reported cases of scrub typhus-associated acute pancreatitis.
- To understand the clinical features, management, and outcomes of this complication.
- To raise awareness among clinicians in endemic areas.
Main Methods:
- A systematic literature review was performed using PubMed.
- Included English, Japanese, and Chinese articles from 1943 to 2024.
- Analyzed 14 cases, including one new case, based on clinical, laboratory, and imaging data.
Main Results:
- Fever, abdominal pain, and thrombocytopenia were common symptoms.
- Over one-third of patients developed multiple organ dysfunction syndrome (MODS) or shock.
- The mortality rate was 23.1%, exclusively in patients with MODS.
Conclusions:
- Acute pancreatitis is an underrecognized, severe complication of scrub typhus.
- MODS significantly increases mortality risk in these patients.
- Prompt diagnosis and aggressive management are vital for improving outcomes.
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