Scrub typhus mimicking enteric fever; a report of three patients

Premaratna, R.; Nawasiwatte, B.M.T.P.; Niriella, M.A.; Chandrasena, T.G.A.N.; Bandara, N.K.B.K.R.G.W.; Rajapakse, R.P.V.J.; de Silva, H.J.

doi:10.1016/j.trstmh.2009.08.011

« PreviousTransactions of the Royal Society of Tropical Medicine and Hygiene
Volume 104, Issue 4 , Pages 309-310, April 2010

Scrub typhus mimicking enteric fever; a report of three patients

R. Premaratna
- Department of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka
- Corresponding author. Tel.: +94 11 2958039x119.
B.M.T.P. Nawasiwatte
- Department of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka
M.A. Niriella
- Department of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka
T.G.A.N. Chandrasena
- Department of Parasitology, University of Kelaniya, Ragama, Sri Lanka
N.K.B.K.R.G.W. Bandara
- Department of Microbiology, University of Kelaniya, Ragama, Sri Lanka
R.P.V.J. Rajapakse
- Department of Veterinary Medicine, University of Peradeniya, Peradeniya, Sri Lanka
H.J. de Silva
- Department of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka

Received 5 May 2009; received in revised form 28 August 2009; accepted 28 August 2009.

Abstract

We report three patients who presented with fever and late onset diarrhoea mimicking enteric fever. All three patients were diagnosed with an Orientia tsutsugamushi infection and responded dramatically to doxycycline treatment. Clinicians practicing in rickettsial disease endemic areas should be made aware of similar clinical presentations in order to prevent morbidity and mortality associated with rickettsioses.

Keywords: Scrub typhus, Orientia tsutsugamushi, Diarrhoea, Rickettsioses, Enteric fever, Sri Lanka