Disseminated Intravascular Coagulation Manifesting as Diffuse Alveolar Hemorrhage in a Scrub Typhus Patient: A Rarely Thought of Complication. 2022

Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
General Medicine, Tata Main Hospital, Jamshedpur, IND.

Scrub typhus is a common cause of an acute, unexplained febrile illness. Without proper treatment, it can lead to life-threatening complications and even death. We present the case of a 16-year-old girl who presented with complaints of fever with reddish spots all over her body for 10 days and breathing difficulty for three days. She had an episode of gum bleeding just prior to admission and two episodes of hemoptysis after admission. She had severe thrombocytopenia, a low serum fibrinogen level, raised D-dimer levels, a raised activated partial thromboplastin time as well as a raised prothrombin time, and an international normalized ratio. Her chest radiograph showed diffuse bilateral interstitial infiltrates. A diagnosis of disseminated intravascular coagulation and diffuse alveolar hemorrhage secondary to possible hematological malignancy or vector-borne infectious disease was made. She was treated with intravenous doxycycline and broad-spectrum antibiotics, along with other supportive measures. Bone marrow aspiration and biopsy showed normal trilineage differentiation, normal erythropoiesis, myelopoiesis, and megakaryopoiesis. Finally, a positive immunoglobulin M (IgM) antibody for scrub typhus clinched the diagnosis. Her condition improved over the next week, and she was discharged with the advice to continue oral doxycycline for a week. This case highlights one of the rare complications of scrub typhus, disseminated intravascular coagulation, and the importance of timely initiation of treatment in such patients.

UI MeSH Term Description Entries

Related Publications

Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
October 1971, The American journal of the medical sciences,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
March 1999, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
July 1991, Rinsho byori. The Japanese journal of clinical pathology,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
November 1991, Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
October 2012, Emergency medicine Australasia : EMA,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
January 1973, Atti della Accademia medica lombarda,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
July 2003, Clinical nephrology,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
September 1981, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
May 1972, Medizinische Monatsschrift,
Mayank Pandey, and Sangita Kamath, and Ajatshatru Upadhyay, and Kreetee Dubey
November 2022, Journal of medical cases,
Copied contents to your clipboard!