Hot to manage scrub typhus symptoms?

Question

Hello doctor,

My sister, who is 46, had scrub typhus two years ago, but now she is experiencing strange symptoms again. It started with a high fever and severe body pain. We initially thought it was the flu, but now she is developing red marks on her legs that look similar to the ones she had last time. Back then, she was treated with injections and antibiotics and recovered, but this time it is worse. She is feeling so weak that she cannot even get out of bed. The local clinic has not been very helpful. They just told us to continue with Doxycycline, but it does not seem to be working. Could the scrub typhus have been reactivated? Should we be looking for a specialist? What tests can confirm if it is back?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

While it is possible for scrub typhus to reactivate in certain patients, one cannot make a definitive diagnosis based on previous exposure alone. I suggest she undergo a few tests that can be done to confirm the diagnosis including:

PCR (polymerase chain reaction).
IFA (indirect immunofluorescence assay).

These are antibody tests. In the case of your sister, if Doxycycline is not working, Chloramphenicol is an alternative drug of choice, with a suggested dose of 500 to 1000 mg daily for one week. I suggest she consult a specialist, talk to them, and take the medications with their consent.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.