Can scrub typhus cause long-term complications?

Question

Hello doctor,

My cousin had a high fever last week, and now he has swollen lymph nodes and a strange rash on his arms. The doctor said it might be scrub typhus, but we had never heard of it before. How serious is this?

He is 26 years old and was completely fine until this sudden fever. They gave him some medication, but the fever kept coming back at night.

Is it normal for this to last more than a week?

Also, does it cause any long-term damage, such as to the liver or heart?

We are really worried because his joints have also started hurting.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Symptoms of scrub typhus usually begin within ten days after infection. Signs and symptoms include:

Fever and chills.
Headache.
Body aches and muscle pain.
A dark, scab-like region at the site of the chigger bite (also known as eschar).
Mental changes, ranging from confusion to coma.
Enlarged lymph nodes.
Rash.

If not treated appropriately, scrub typhus can be fatal and may lead to organ damage and severe bleeding.

Complications – Can Be Serious

Acute respiratory distress syndrome (ARDS): A severe complication that requires prompt diagnosis and treatment.
Acute kidney injury (AKI).
Myocarditis: A complication that can be life-threatening.
Acute liver failure (ALF).
Encephalitis.
Pericarditis.
Cardiac arrhythmia.
Acute hearing loss.
Septic shock.
Multiple organ dysfunction syndrome (MODS)

I suggest the following treatment:

Capsule Doxycycline (tetracycline) 100 milligrams twice daily for seven days – drug of choice.
Tablet Paracetamol (analgesic) 500 milligrams three times daily for five days.
Tablet Pantoprazole (proton pump inhibitor (PPI)) 40 milligrams once daily on an empty stomach in the morning for seven days

The earlier Doxycycline is started, the better the results. Generally, patients begin recovering within a week. However, joint pain is not commonly reported by many patients, so it would be advisable to review the joint pain with an orthopedic specialist. To check for liver damage, certain tests can be performed.

If symptoms persist for three to four more days, consider consulting a doctor again or admitting the patient to the hospital.

Kindly consult a physician, discuss with them, and start taking the medications with their consent.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.