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

Year: 2025

Type: article

Abstract: 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.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-025-12008-9

Authors: Kajananan Sivagurunathan, Nishadi Perera, Anuranga Senanayake

Institution: Kilinochchi General Hospital

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: $3,090