title: Duodenal Perforation Precipitated by Scrub Typhus.
abstract: Scrub typhus is an acute febrile illness usually presenting with fever, myalgia, headache, and a pathognomonic eschar. Severe infection may lead to multiple organ failure and death. Gastrointestinal tract involvement in the form of gastric mucosal erosions and ulcerations owing to vasculitis resulting in gastrointestinal bleeding is common. This process may worsen a pre-existent asymptomatic peptic ulcer, causing duodenal perforation, and present as an acute abdomen requiring surgical exploration. We report the case of a patient with no previous symptoms or risk factors for a duodenal ulcer, who presented with an acute duodenal perforation, probably precipitated by scrub typhus infection.
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Raghunath
authors.initials: R
authors.lastname: Rajat
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: David
authors.initials: D
authors.lastname: Deepu
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Arul Jeevan
authors.initials: AJ
authors.lastname: Jonathan
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Abhilash Kundavaram Paul
authors.initials: AK
authors.lastname: Prabhakar
keywords: Scrub typhus; acute abdomen; duodenal perforation