Work

Scrub typhus with urinary tract infection and leukopenia: A case series

Year: 2024

Type: article

Abstract: Urinary tract infection Leukopenia Dear Editor:Scrub typhus is a mite-borne disease caused by Orientia tsutsugamushi.The common manifestations of scrub typhus include fever, pneumonia, liver dysfunction, and acute kidney injury [1].Leukopenia and urinary tract infection (UTI) caused by O. tsutsugamushi have rarely been reported.Herein, we reported four scrub typhus cases presenting as UTIs with leukopenia in Shandong Province, China.Case 1.A 67-year-old man presented to the hospital claiming fever, fatigue, muscle soreness, and cough.Enlarged lymph nodes in the groin and skin lesion produced by arthropod bite was observed.Laboratory results showed bronchitis, leukopenia, hematuria, and proteinuria, with the urine WBC (white blood cell) and RBC (red blood cell) counts being 19 and 89, respectively.Elevated AST (glutamic oxaloacetic transaminase), ALT (glutamic-pyruvic transaminase), and LDH (lactate dehydrogenase) were also observed (Table_1).He was suspected infected with severe fever with thrombocytopenia syndrome virus (SFTSV) or Brucella sp., then favipiravir and doxycycline were applied.However, subsequent tests were negative for both.On the 12th day, the symptoms were relieved and he left the hospital.Case 2. A 70-year-old woman was admitted with fever, dizziness, fatigue, and muscle soreness for 26 days.Arthropod-bite lesion was recorded and skin rash was observed on the back, hip, and inner thigh.Laboratory results revealed leukopenia, hematuria, and proteinuria, with the urine WBC and RBC counts being 63 and 72, respectively.She was clinically diagnosed with rickettsial infection, invasive pulmonary aspergillosis, and septic shock.Meropenem, voriconazole, and doxycycline were applied.Since the 13th day, her laboratory indicators returned to normal.She left the hospital on the 15th day.Case 3. A 50-year-old woman complaint fever, malaise, headache, chill, anorexia, joint soreness, throat dryness, and nausea for 7 days.Skin lesion, conjunctival congestion, and enlarged tonsils were also described.Hematuria, and proteinuria were indicated by urinalysis, with the urine WBC and RBC counts being 66 and 32, respectively.Routine blood tests also indicated leukopenia, thrombocytopenia, elevated PCT, and elevated LDH.Viral infection was suspected.Favipiravir and piperacillin tazobactam were used.Additionally, granulocyte colony-stimulating factor was applied to increase the WBC.On the 5th day, her body temperature became normal, and she was set free from the hospital.

Source: New Microbes and New Infections

DOI: 10.1016/j.nmni.2024.101548

Authors: Cuiping Wu, Miao Lu, Xuejun Dong, Yitong Jiang, Bo Liang, Kun Li

Institutions: Yidu Central Hospital of Weifang, Chinese Center For Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Capital Medical University

Language: English

Topic: Vector-borne infectious diseases

Subfield: Parasitology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,610