Scrub typhus associated macrophage activation syndrome.
Macrophage activation syndrome (MAS) is a rare phenomenon that occurs either primarily or secondary to a multitude of conditions, including juvenile rheumatoid arthritis most commonly, and other infections like enteric fever and tuberculosis. It has been reported as an extremely rare complication of scrub typhus with no cases presented from India. We report three cases of scrub typhus presenting with confirmed MAS between January 2007 and December 2007 to a tertiary care hospital in South India. All three patients had clinical and laboratory evidence for scrub typhus and MAS. All the patients responded promptly to antibiotics and made an uneventful recovery. These three patients are presented to highlight the importance of considering scrub typhus in patients with MAS following acute febrile illnesses.
Gopal
Gopinath Kango
GK
Department of Medicine - 3, Christian Medical College, Vellore, India. gops95@yahoo.com
Anugrah
Chrispal
C
Boorugu
Harikishan
H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D004318:Doxycycline / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007075:Immunoglobulin M; D055501:Macrophage Activation Syndrome / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000302:isolation & purification*; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007075:Immunoglobulin M; D004318:Doxycycline