How to manage severe scrub typhus?

Question

Hello doctor,

My 42-year-old husband just returned from a hiking trip and has been diagnosed with scrub typhus, confirmed by the hospital. He has had a 104 degrees Fahrenheit fever for six days that will not break, even after starting antibiotics (Doxycycline 100 mg) two days ago. The black scab where a tick bit him on his neck is getting bigger, and he now has swollen lymph nodes that are extremely painful. He became confused when his fever spiked and did not recognize our daughter this morning. Blood tests show his platelets are at 45,000, and his liver enzymes are elevated: ALT 342, AST 289. The hospital wants to transfer him to the ICU, but there are no available beds. Should we consider transferring him to a different hospital? What complications should we watch for with scrub typhus at this stage?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I am very sorry to hear about your husband's condition. Scrub typhus can be severe and requires close monitoring. Given his high fever, confusion, low platelet count, and elevated liver enzymes, it is crucial to ensure he receives the best care possible. If the current hospital cannot provide an intensive care unit (ICU) bed, transferring him to another hospital with available ICU beds is advisable.

Complications to watch for include:

Respiratory distress: Difficulty breathing or rapid breathing.
Neurological symptoms: Increased confusion, seizures, or loss of consciousness.
Organ failure: Worsening liver function, kidney issues, or heart problems.
Bleeding: Due to low platelets, watch for unusual bruising or bleeding.

Please feel free to book a consultation with me if you would like more detailed information on any of these points or if you have other questions.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.