Treating Yourself for Scrub Typhus: The Dangers of Self-Diagnosis and Why Prompt Medical Attention is Critical

A man suffering from high fever and fatigue self-treated himself for four days before being diagnosed with septic shock and multiple organ failure at the provincial hospital. Despite being treated with dialysis, a ventilator, and intravenous broad-spectrum antibiotics, his condition did not improve. In critical condition, he was transferred to the 108 Central Military Hospital with circulatory collapse, myocarditis, progressive acute respiratory failure, acute liver and kidney damage, and thrombocytopenia.

Doctors at the 108 Military Central Hospital identified an ulcer on the patient’s right chest as typical of scrub typhus on July 2. Tests confirmed that he was infected with Orientia tsutsugamushi, the pathogen that causes scrub typhus. Following diagnosis, he was treated with specific antibiotics and supportive measures for organ failure. Currently, his fever has subsided, his breathing has improved, and his organ failure is showing signs of recovery.

Scrub typhus is an acute infectious disease transmitted through the bite of mite larvae that is caused by Orientia tsutsugamushi. Its diverse manifestations include prolonged high fever, severe headache, skin and mucous membrane congestion, and rash. Skin ulcers can form at the site of the larval bite in soft or moist skin areas but are usually painless and not itchy. Most cases will have just one ulcer but can also have two or three. It’s important for individuals in endemic areas to take precautions when staying or working in environments favored by scrub typhus larvae to prevent this dangerous but preventable disease from occurring again.

Prompt medical attention is recommended for fevers of unknown origin accompanied by potential risk factors for scrub typhus to avoid a similar outcome as this patient who required a transfer to a specialized hospital despite initially trying to treat himself at home without improvement.