Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6900-6906
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6900
Manifestation of acute peritonitis and pneumonedema in scrub typhus without eschar: A case report
Xiu-Ling Zhou, Qing-Long Ye, Jia-Qian Chen, Wei Li, Hao-Jian Dong
Xiu-Ling Zhou, Qing-Long Ye, Jia-Qian Chen, Wei Li, Hao-Jian Dong, Department of Internal Medicine, Guangdong Provincial People’s Hospital Zhuhai Hospital (Zhuhai Golden Bay Center Hospital), Zhuhai 519000, Guangdong Province, China
Author contributions: Zhou XL wrote the manuscript; Ye QL contributed to data collection and analysis; Li W and Chen JQ helped perform the analysis with constructive discussions; Dong HJ contributed to critical review and revision of the manuscript; all the authors have read and approved the final manuscript.
Supported by the National Key Research and Development Program of China, No. 2016YFC1301202.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao-Jian Dong, MD, PhD, Chief Physician, Department of Internal Medicine, Guangdong Provincial People’s Hospital Zhuhai Hospital (Zhuhai Golden Bay Center Hospital), No. 2 Hongyang Road, Jinwan District, Zhuhai 519000, Guangdong Province, China. donghaojian@sina.com
Received: April 24, 2021
Peer-review started: April 24, 2021
First decision: May 24, 2021
Revised: June 3, 2021
Accepted: June 16, 2021
Article in press: June 16, 2021
Published online: August 16, 2021
Core Tip

Core Tip: We report a case of scrub typhus mainly manifesting as diffuse peritonitis, pulmonary edema, and other multiorgan dysfunction, but lacking typical eschar, and the first Weil-Felix test was negative. Tracing back his travel history of jungle activities 5 d before the onset, doxycycline (100 mg q12h) was added empirically to cover atypical bacteria. He was finally discharged in a relatively stable condition under appropriate antibiotics including meropenem and doxycycline 7 d after admission. This rare presentation of peritonitis, pulmonary edema, and pancreatitis caused by scrub typhus reminds physicians to be alert to the possibility of scrub typhus.