What are the tests to diagnose a scrub typhus infection?

Question

Hello doctor,

I am a 37-year-old veterinarian who recently returned from volunteering at an animal rescue center. About 10 days after returning, I developed a high fever, chills, and body aches. During the trip, I noticed a small, painless sore with a dark scab on my lower back, but I did not think it was serious then. I have also developed a blotchy rash on my chest and upper arms in the last two days. My blood tests show slightly raised liver enzymes. Could this be scrub typhus or another disease spread by insects? What tests should I take, and is there a specific treatment?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your symptoms could be due to scrub typhus, dengue, or malaria, so it is crucial to confirm the diagnosis. Given your symptoms and recent travel history, scrub typhus appears to be a strong possibility. To help identify the exact cause, several blood tests are recommended. These include a PCR (polymerase chain reaction) test to confirm scrub typhus, a Dengue NS1 antigen test to rule out dengue, and a peripheral smear (PS) to check for malarial parasites. Liver function tests are also important, as scrub typhus often causes elevated levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST).

Treatment:

Doxycycline 100 milligrams – twice daily for seven days.
Paracetamol 500 milligrams – three times daily for five days (for fever and pain).
Pantoprazole 40 milligrams – once daily on an empty stomach for seven days (to protect your stomach).

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

Thank you.