title: Spontaneous Splenic Rupture Caused by Scrub Typhus.
abstract: Spontaneous rupture of the spleen is rarely described as a complication of scrub typhus infection. We report a previously healthy 74-year-old Thai female farmer who presented in Nakhon Ratchasima, Thailand, with a history of fever and malaise for 5 days, followed by abdominal pain for 1 day. An exploratory laparotomy was performed due to peritonitis. Operative findings revealed a ruptured spleen and hemoperitoneum. A splenectomy was performed afterward. Scrub typhus was confirmed by a 4-fold increase of IgM titer using an indirect immunofluorescence antibody assay and a positive result from the polymerase chain reaction targeting the 47- and 56-kDa genes in Orientia tsutsugamushi She responded well to intravenous chloramphenicol and defervesced within 24 hours without any complication.
authors.affiliation: Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand. wthipmontree@gmail.com.
authors.forename: Wilawan
authors.initials: W
authors.lastname: Thipmontree
authors.affiliation: Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
authors.forename: Kittipong
authors.initials: K
authors.lastname: Suwattanabunpot
authors.affiliation: Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Yupin
authors.initials: Y
authors.lastname: Supputtamonkol
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002701:Chloramphenicol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D012612:Scrub Typhus / Q000150:complications* / Q000188:drug therapy; D013161:Splenic Rupture / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013785:Thailand
chemical_list: D000900:Anti-Bacterial Agents; D002701:Chloramphenicol