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ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE.

Abstract

Scrub typhus rarely presents with acute cholecystitis. We present 2 cases of scrub typhus with cholecystitis. The first patient is a 62 year old female who presented to the hospital with fever and body aches for 1 week and right upper quadrant abdominal pain for 3 days. She gave a history of an insect bite 2 weeks previously. She was diagnosed as having acute cholecystitis and underwent cholecystectomy. She continued with fever post-operatively and physical examination revealed an eschar. She had an immunofluorescence assay (IFA) performed that revealed a high IgM titer for Orientia tsutsugamushi. She was diagnosed as having scrub typhus, treated with doxycycline and she recovered completely. The second patient also presented to the hospital with a 1 week history of fever and upper quadrant abdominal pain. She was diagnosed with having cholecystitis. Her symptoms did not improve with intravenous antibiotics and further investigation revealed elevated titers for O. tsutsugamushi and Leptospira interrogans. She was diagnosed as having a co-infection of scrub typhus and leptospirosis and treated with doxycycline. She recovered completely. Patients from scrub typhus endemic regions who present with acute cholecystitis but do not respond to traditional treatment should be tested for scrub typhus and leptospirosis and should have a careful admission physical examination looking for eschar formation, since scrub typhus may present with acute cholecystitis.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

29644830

Citation

Charoenphak, Sirima, et al. "ACUTE CHOLECYSTITIS as an UNUSUAL PRESENTATION of SCRUB TYPHUS: a REPORT of TWO CASES and REVIEW of the LITERATURE." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 48, no. 1, 2017, pp. 143-9.
Charoenphak S, Rattanawong P, Sungkanuparph S. ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE. Southeast Asian J Trop Med Public Health. 2017;48(1):143-9.
Charoenphak, S., Rattanawong, P., & Sungkanuparph, S. (2017). ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE. The Southeast Asian Journal of Tropical Medicine and Public Health, 48(1), 143-9.
Charoenphak S, Rattanawong P, Sungkanuparph S. ACUTE CHOLECYSTITIS as an UNUSUAL PRESENTATION of SCRUB TYPHUS: a REPORT of TWO CASES and REVIEW of the LITERATURE. Southeast Asian J Trop Med Public Health. 2017;48(1):143-9. PubMed PMID: 29644830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE. AU - Charoenphak,Sirima, AU - Rattanawong,Pattara, AU - Sungkanuparph,Somnuek, PY - 2018/4/13/entrez PY - 2017/1/1/pubmed PY - 2018/5/16/medline SP - 143 EP - 9 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 48 IS - 1 N2 - Scrub typhus rarely presents with acute cholecystitis. We present 2 cases of scrub typhus with cholecystitis. The first patient is a 62 year old female who presented to the hospital with fever and body aches for 1 week and right upper quadrant abdominal pain for 3 days. She gave a history of an insect bite 2 weeks previously. She was diagnosed as having acute cholecystitis and underwent cholecystectomy. She continued with fever post-operatively and physical examination revealed an eschar. She had an immunofluorescence assay (IFA) performed that revealed a high IgM titer for Orientia tsutsugamushi. She was diagnosed as having scrub typhus, treated with doxycycline and she recovered completely. The second patient also presented to the hospital with a 1 week history of fever and upper quadrant abdominal pain. She was diagnosed with having cholecystitis. Her symptoms did not improve with intravenous antibiotics and further investigation revealed elevated titers for O. tsutsugamushi and Leptospira interrogans. She was diagnosed as having a co-infection of scrub typhus and leptospirosis and treated with doxycycline. She recovered completely. Patients from scrub typhus endemic regions who present with acute cholecystitis but do not respond to traditional treatment should be tested for scrub typhus and leptospirosis and should have a careful admission physical examination looking for eschar formation, since scrub typhus may present with acute cholecystitis. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/29644830/ACUTE_CHOLECYSTITIS_AS_AN_UNUSUAL_PRESENTATION_OF_SCRUB_TYPHUS:_A_REPORT_OF_TWO_CASES_AND_REVIEW_OF_THE_LITERATURE_ L2 - http://www.diseaseinfosearch.org/result/1342 DB - PRIME DP - Unbound Medicine ER -