title: Surgical manifestations of scrub typhus: A diagnostic dilemma.
abstract: Scrub typhus, a zoonosis caused by Orientia tsutsugamushi, is a systemic febrile illness. The disease presents with diverse clinical manifestations, ranging from subclinical disease to multiorgan failure and fatal disease. It may rarely present as an acute abdomen which may lead to a diagnostic dilemma. We describe two serologically confirmed cases of scrub typhus presenting as acute abdomen-one mimicking acute appendicitis and the other acute cholecystitis, both managed non-operatively. A high index of suspicion, along with subtle indicators in the history and clinical examination help avoid unnecessary surgery in such cases.
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore 632004, Tamil Nadu, gayatrisabne@rediffmail.com.
authors.forename: Gayatri Amit
authors.initials: GA
authors.lastname: Deshpande
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore 632004, Tamil Nadu.
authors.forename: Rohin
authors.initials: R
authors.lastname: Mittal
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore 632004, Tamil Nadu.
authors.forename: Mark Rajan
authors.initials: MR
authors.lastname: Jesudasan
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore 632004, Tamil Nadu.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Perakath
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D001064:Appendicitis / Q000175:diagnosis; D041881:Cholecystitis, Acute / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012612:Scrub Typhus / Q000175:diagnosis*; D055815:Young Adult