title: Scrub typhus mimicking deep neck infection.
abstract: Scrub typhus is not uncommon in Asia and it is life threatening without correct treatment. The presentation of scrub typhus mimicking deep neck infection is rarely encountered by clinical physicians and delays the determination of the correct diagnosis. Here, we report a case of scrub typhus presenting symptoms like deep neck infection. The patient was admitted due to fever and a tender swelling on left side of his neck, which progressed to respiratory failure and acute renal failure under empirical use of ceftriaxone and metronidazole. After repetitive physical examinations, an eschar was found on his scalp. Finally he was successfully treated with tetracycline antibiotics.
authors.affiliation: Department of Medicine, Section of Infectious Disease, Buddhist Dalin Tzu Chi General Hospital and Tzu Chi University, Chiayi, Taiwan. antibody_1@msn.com
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
authors.forename: Dung-Hung
authors.initials: DH
authors.lastname: Chiang
authors.forename: Ruay-Wang
authors.initials: RW
authors.lastname: Duh
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009333:Neck / Q000382:microbiology / Q000473:pathology*; D012285:Orientia tsutsugamushi; D012612:Scrub Typhus / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents