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Background <p>Scrub typhus is a mite-borne rickettsial infection endemic to parts of Asia, including Sri Lanka, with a wide range of clinical manifestations.</p> Case presentation <p>We report a rare case of a 16-year-old male who presented with a seven-day febrile illness complicated by hypoxemia and pulmonary congestion. Clinical examination revealed an eschar and inguinal lymphadenopathy, raising strong suspicion of scrub typhus, which was subsequently confirmed by a Weil-Felix OXK titer of 1:1280. Despite initial suspicion of myocarditis, cardiac and renal evaluations were normal, and the patient rapidly improved with doxycycline and low-dose frusemide. The clinical course, absence of organ dysfunction, and prompt radiological resolution supported a diagnosis of noncardiogenic pulmonary edema. ARDS was considered unlikely and was ruled out.</p> Conclusion <p>This case highlights scrub typhus as a rare cause of pulmonary edema occurring in the absence of cardiac and renal involvement, underscoring the need for clinical awareness in endemic regions.</p> Clinical trial number <p>Not applicable.</p>

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A case of acute pulmonary edema in scrub typhus: a rare complication with normal cardiac and renal function

  • 期刊论文

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  • 发表日期：

    2025年11月11日

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  • Kajananan Sivagurunathan,
  • Nishadi Perera,
  • Anuranga Senanayake

摘要

Background

Scrub typhus is a mite-borne rickettsial infection endemic to parts of Asia, including Sri Lanka, with a wide range of clinical manifestations.

Case presentation

We report a rare case of a 16-year-old male who presented with a seven-day febrile illness complicated by hypoxemia and pulmonary congestion. Clinical examination revealed an eschar and inguinal lymphadenopathy, raising strong suspicion of scrub typhus, which was subsequently confirmed by a Weil-Felix OXK titer of 1:1280. Despite initial suspicion of myocarditis, cardiac and renal evaluations were normal, and the patient rapidly improved with doxycycline and low-dose frusemide. The clinical course, absence of organ dysfunction, and prompt radiological resolution supported a diagnosis of noncardiogenic pulmonary edema. ARDS was considered unlikely and was ruled out.

Conclusion

This case highlights scrub typhus as a rare cause of pulmonary edema occurring in the absence of cardiac and renal involvement, underscoring the need for clinical awareness in endemic regions.

Clinical trial number

Not applicable.