Indian Journal of Critical Care Case Report

Register      Login

VOLUME 1 , ISSUE 1 ( July-August, 2022 ) > List of Articles


Leukemoid Reaction Associated with Scrub Typhus Infection: A Rare Case Report with a Review of Literature

Tatikonda Chandra Mouli, Rupali Patnaik, Priyanka Samal, Sarita Pradhan, Shakti Bedanta Mishra

Keywords : Fever with rash, Leukemoid reaction, Scrub typhus

Citation Information : Mouli TC, Patnaik R, Samal P, Pradhan S, Mishra SB. Leukemoid Reaction Associated with Scrub Typhus Infection: A Rare Case Report with a Review of Literature. 2022; 1 (1):23-25.

DOI: 10.5005/jp-journals-11006-0009

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Scrub typhus is a tropical disease caused by the rickettsia group of obligate intracellular bacterium, Orientia tsutsugamushi, which usually presents as fever with rash. Scrub typhus has a wide spectrum of involvement which include acute kidney injury, thrombocytopenia, leukopenia, and hepatopathy. Leukemoid reaction is a reactionary proliferation of white blood cells secondary to stress or infection. Leukopenia is scrub typhus norm, but our patient developed a lymphocyte-predominant leukemoid reaction. The patient had hypofibrinogenemia and platelet dysfunction, which was detected early by rotational thromboelastometry (ROTEM) analysis. We are bringing forward a case of scrub typhus with a leukemoid reaction.

PDF Share
  1. Premaratna R. Rickettsial illnesses, a leading cause of acute febrile illness. Clin Med 2022;22(1):2–5. DOI: 10.7861/clinmed.2021-0790
  2. Pazhaniyandi S, Lenin R, Sivathanu S. Hemophagocytic lymphohistiocytosis with a leukemoid reaction in an infant with scrub typhus. J Infect Public Health 2015;8(6):626–629. DOI: 10.1016/j.jiph.2015.05.012
  3. Kim MH, Kim SH, Choi JH, et al. Clinical and laboratory predictors associated with complicated scrub typhus. Infect Chemother 2019;51(2):161–170. DOI: 10.3947/ic.2019.51.2.161
  4. Watanabe Y, Mashimo S, Ichige H, et al. Scrub typhus mimicking the clinical course of infectious mononucleosis: a case report. J Rural Med 2021;16(1):62–66. DOI: 10.2185/jrm.2020-037
  5. Kar A, Dhanaraj M, Dedeepiya D, et al. Acute encephalitis syndrome following scrub typhus infection. Indian J Crit Care Med 2014;18(7):453–455. DOI: 10.4103/0972-5229.136074
  6. Venkategowda PM, Rao SM, Mutkule DP, et al. Scrub typhus: clinical spectrum and outcome. Indian J Crit Care Med 2015;19(4):208–213. DOI: 10.4103/0972-5229.154553
  7. Lu CT, Wang LS, Hsueh PR. Scrub typhus and antibiotic-resistant Orientia tsutsugamushi. Expert Rev Anti Infect Ther 2021;19(12):1519–1527. DOI: 10.1080/14787210.2021.1941869
  8. Wickramasinghe W, Alvitigala BY, Perera T, et al. Rotational thromboelastometry in the critical phase of dengue infection: association with bleeding. Res Pract Thromb Haemost 2022;6(3):e12704. DOI: 10.1002/rth2.12704
  9. Musa TH, Ahmad T, Wana MN, et al. The epidemiology, diagnosis and management of scrub typhus disease in China. Hum Vaccin Immunother 2021;17(10):3795–3805. DOI: 10.1080/21645515.2021.1934355
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.