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VOLUME 18 , ISSUE 7 ( July, 2014 ) > List of Articles

CASE REPORT

Scrub typhus presenting as Purpura fulminans

Bijayini Behera, Suhasini Tirumala, Srikanth Jawalkar, Pradeep Kumar Mishra, Pavithra Vani Patalay, Sudha Ayyagari, Pavani Nimmala

Keywords : Indian tick typhus, purpura, Rickettsia, Weil-Felix test, doxycycline

Citation Information : Behera B, Tirumala S, Jawalkar S, Mishra PK, Patalay PV, Ayyagari S, Nimmala P. Scrub typhus presenting as Purpura fulminans. Indian J Crit Care Med 2014; 18 (7):476-478.

DOI: 10.4103/0972-5229.136081

License: CC BY-ND 3.0

Published Online: 01-07-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Seriously ill patients presenting with purpura fulminans, sepsis and multi-organ failure often require extensive diagnostic workup for proper diagnosis and management. Host of common infections prevalent in the tropics, e.g. malaria, dengue; other septicemic infections e.g. meningococcemia, typhoid, leptospirosis, toxic shock syndrome, scarlet fever, viral exanthems like measles, infectious mononucleosis, collagen vascular diseases (Kawasaki disease, other vasculitis) diseases, and adverse drug reactions are often kept in mind, and the index of suspicion for rickettsial illness is quite low. We present a case of Indian tick typhus presenting with purpura fulminans (retiform purpura all over the body), sepsis and multiorgan failure without lymphadenopathy and eschar, successfully treated with doxycycline and discharged home. Hence, a high index clinical suspicion and prompt administration of a simple therapy has led to successful recovery of the patient.


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