• Sao Paulo Med J · Jan 2024

    Case Reports

    Case report of scrub typhus complicated by hypokalemia and multiple organ dysfunction syndrome.

    • Li Chen, Yi Deng, Peiying Huang, Sisi Lei, Shuling Liu, Weitao Lin, Zhishang Li, Jing Zeng, Miaochun Huang, Qiuping Huang, Qihua Wu, Haobo Zhang, and Bojun Chen.
    • MD. Associate Chief Physician, Associate Professor, Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China; Member, Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Clinical Research Team for Prevention and Treatment of Cardiac Emergencies with Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China.
    • Sao Paulo Med J. 2024 Jan 1; 142 (4): e20230142e20230142.

    ContextScrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus.Case ReportA 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17.ConclusionThis report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.

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