Key result
Doxycycline and low-dose frusemide rapidly resolve rare scrub typhus-induced noncardiogenic pulmonary edema.
Case Report (n=1)
No
Scrub typhus can rarely cause noncardiogenic pulmonary edema in the absence of cardiac and renal involvement.
Answers are grounded in this paper and cite their sources.
Clinicians should consider noncardiogenic pulmonary edema in scrub typhus; case report leaves open its incidence and mechanisms.
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.
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Sivagurunathan et al. (2025) conducted a case report in Scrub typhus with acute pulmonary edema (n=1). Doxycycline and frusemide was evaluated on Resolution of symptoms and pulmonary edema. A 16-year-old male with scrub typhus developed rare noncardiogenic pulmonary edema without cardiac or renal dysfunction, which rapidly resolved with doxycycline and low-dose frusemide.
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