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Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus

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ABSTRACT Introduction Scrub typhus is an acute, febrile zoonosis, caused by an obligate intracellular bacterium Orientia tsutsugamushi. The disease is of greatest public health importance in rural areas of Asia and in Western Pacific Islands. The clinical manifestations of the disease range from subclinical disease to an organ failure. The various complications known with this disease are jaundice, renal failure, pneumonitis, acute respiratory distress syndrome, septic shock, myocarditis, vasculitis, and meningoencephalitis. The complications of scrub typhus usually develop after the first week of illness. Case report We report a case of a 70-year-old female, farmer by occupation, who presented with acute febrile illness and was diagnosed as scrub typhus. She subsequently developed vasculitis, which resulted in pan digital gangrene. After thorough workup for digital gangrene, it was established that scrub typhus is the cause of gangrene in this patient. Conclusion Thus, our inference is that vasculitis might be seen in very few cases of scrub typhus and it may progress up to gangrene of digits. Only one such case has been reported, thus making it a very rare phenomenon. How to cite this article Rijhwani P, Charan A, Agrawal CM, Pahadia MR, Gupta S, Anand H. Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus. J Mahatma Gandhi Univ Med Sci Tech 2017;2(1):35-37.
Title: Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus
Description:
ABSTRACT Introduction Scrub typhus is an acute, febrile zoonosis, caused by an obligate intracellular bacterium Orientia tsutsugamushi.
The disease is of greatest public health importance in rural areas of Asia and in Western Pacific Islands.
The clinical manifestations of the disease range from subclinical disease to an organ failure.
The various complications known with this disease are jaundice, renal failure, pneumonitis, acute respiratory distress syndrome, septic shock, myocarditis, vasculitis, and meningoencephalitis.
The complications of scrub typhus usually develop after the first week of illness.
Case report We report a case of a 70-year-old female, farmer by occupation, who presented with acute febrile illness and was diagnosed as scrub typhus.
She subsequently developed vasculitis, which resulted in pan digital gangrene.
After thorough workup for digital gangrene, it was established that scrub typhus is the cause of gangrene in this patient.
Conclusion Thus, our inference is that vasculitis might be seen in very few cases of scrub typhus and it may progress up to gangrene of digits.
Only one such case has been reported, thus making it a very rare phenomenon.
How to cite this article Rijhwani P, Charan A, Agrawal CM, Pahadia MR, Gupta S, Anand H.
Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus.
J Mahatma Gandhi Univ Med Sci Tech 2017;2(1):35-37.

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