Title: Empyema Thoracis: An Unusual Presentation of a Child with Scrub Typhus
Authors: Dr Sunil Kumar Agarwalla, Dr Laxmipriya Tudu
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.50
Abstract
Scrub typhus is a febrile zoonosis caused by an obligate intracellular proteobacterium, Orientia tsutsugamushi. It is most common zoonosis of public health importance in rural areas of South East Asia, Northern Australia and Pacific island. The clinical spectrum of disease varies from acute febrile illness to multi organ involvement with systemic complications. Scrub typhus is still under-diagnosed as the clinical manifestation is often atypical leading to low index of suspicion among Clinicians. Delay in diagnosis and treatment often lead to increased morbidity and mortality. Any fever without focus (FWF) with a black ulcer (eschar) or edema, rash or AES like presentation one has to rule out the possibility of scrub typhus.
We report a case of 20 month old boy, presented as Scrub typhus found to have right sided empyema thoracis as an unusual presentation. Patient recovered with intercostal drainage and antibiotics ceftriaxone, vancomycin & doxycycline treatment.
Keywords: Zoonosis, Eschar, scrub typhus, Empyema, intercostal drainage.
