Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness. Characteristics of tsutsugamushi disease are fever, rash and eschar. However, severe complications might rarely occur, such as acute fulminant myocarditis caused by scrub typhus. Thus, there are few reports of recovery from seriously complicated cases. We report on an adult male with scrub typhus complicated with acute fulminant myocarditis with no previous comorbid illness who recovered successfully with proper treatment including antibiotics, ventilator support, percutaneous cardiopulmonary support, and continuous renal replacement therapy.

Citations

Citations to this article as recorded by  

• Comprehensive review on cardiac manifestation of scrub typhus
  Barath Prashanth Sivasubramanian, Abul Hasan Shadali Abdul Khader, Diviya Bharathi Ravikumar, Francis Vino Dominic Savio, Umabalan Thirupathy, Varshini Thiruvadi, Rhea Prasad, Hema Thokala, Husna Qadeer, Dhiraj Poragal Venkataperumal, Ashima Gupta, Nagara
  Frontiers in Tropical Diseases.2024;[Epub]     CrossRef
• Case Report: Fulminant Myocarditis Successfully Treated With Extracorporeal Membrane Oxygenation in Ikeda Strain Orientia tsutsugamushi Infection
  Hyejin Park, Yongwhan Lim, Min Chul Kim, Seong Eun Kim, In-Seok Jeong, Yoo Duk Choi, Dong-Min Kim
  Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
• A case report of scrub typhus complicated with myocarditis and rhabdomyolysis
  Young-Jae Ki, Dong-Min Kim, Na-Ra Yoon, Sung-Soo Kim, Choon-Mee Kim
  BMC Infectious Diseases.2018;[Epub]     CrossRef

A 30-year-old man visited the emergency room for chest pain, dyspnea and fever. Despite increased serum cardiac enzymes, ST segment elevation and inferior wall akinesis in electrocardiography and echocardiography, no atherosclerosis was evident in the coronary angiography. However, radionuclide myocardial perfusion image at day 2 showed a persistent perfusion defect in the left ventricular (LV) inferior wall. At day 3, prominent myocardial edema and severe LV systolic dysfunction developed with signs of heart failure. In this case, fulminant myocarditis seemed to originate from the right coronary artery territory and simulated a ST segment elevation myocardial infarction without coronary artery obstruction. The pathogenesis of the localized perfusion defect was unlcear.