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What is the treatment plan for scrub typhus infection?

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Patient's Query

Hi doctor,

My 35-year-old cousin works on a farm and was recently diagnosed with scrub typhus. They started him on Doxycycline, but he still has a high fever, and his rash seems to be getting worse. Is this normal? My family visits the farm often, so how can we make sure no one else gets it? Do we need to use bug sprays or wear special clothing? I read that ticks or mites spread the disease, so should we get pest control? What are the chances of serious complications? Some people say it can damage organs. How can we tell if it is becoming dangerous? Should he be hospitalized if the fever does not go down?

Kindly help.

Hello,

Welcome to icliniq.com.

I understand your concern.

Doxycycline is typically prescribed for seven days to treat scrub typhus, and patients usually start feeling better after the treatment, especially if it is started early. If your cousin finishes the full dose of Doxycycline and still has a high fever, it is important to visit the doctor for further evaluation.

Complications to watch for:

  1. Acute respiratory distress syndrome (ARDS): A severe complication that needs immediate treatment.

  2. Acute kidney injury (AKI)

  3. Myocarditis: Inflammation of the heart muscle, which can be life-threatening.

  4. Acute liver failure (ALF)

  5. Encephalitis: Inflammation of the Brain.

  6. Pericarditis: Inflammation of the lining around the heart.

  7. Cardiac arrhythmias: Irregular heartbeats.

  8. Acute hearing loss.

  9. Septic shock.

  10. Multiple organ dysfunction syndrome (MODS).

Prevention:

There is no vaccine for scrub typhus. To reduce the risk, avoid areas with dense vegetation or brush where chiggers (the insects that spread the disease) are found. You might also want to consider getting pest control done on the farm.

Not all patients experience complications, but it is important to watch for the signs listed above.

Tests to consider:

  1. Complete blood count (CBC) to monitor changes.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Answered byDr. Reema Wankar

Medically reviewed byiCliniq medical review team

Published At March 25, 2025
Reviewed AtMarch 28, 2025

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