Eschar

Hazra, Darpanarayan; Abhilash, KundavaramPaul Prabhakar; Gunasekharan, K; Prakash, J Saran

doi:10.4103/jpgm.jpgm_1151_20

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…We compared the present case with similar cases of co-infection with SARS-CoV-2 and O. tsutsugamushi previously reported in the literature, including the available signs and symptoms, laboratory findings, treatment, and outcomes ( Table S1 ) [ 39 , 40 , 41 ]. The previous cases included two females and two males, and consisted of one child and three adults.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives

et al. 2023

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The COVID-19 pandemic was the worst public-health crisis in recent history. The impact of the pandemic in tropical regions was further complicated by other endemic tropical diseases, which can cause concurrent infections along with COVID-19. Here, we describe the clinical course of a patient with concurrent COVID-19 and scrub typhus infection. The patient’s de-identified clinical data were retrieved retrospectively. The patient had progressive breathlessness at the time of presentation and was hospitalized for COVID-19. Respiratory examination revealed dyspnea, tachypnea, and coarse crepitations bilaterally over the entire lung field. Oxygenation was impaired, and a PaO2/FiO2 ratio of 229 suggested acute respiratory distress syndrome. Laboratory tests indicated leukocytosis, thrombocytopenia, ferritinemia, hypoalbuminemia, and transaminitis. Upon revaluation for persistent fever, physical examination revealed an eschar in the right antecubital fossa. Serology further confirmed scrub typhus, with IgM and IgG antibody positivity. A remarkable clinical recovery was achieved with doxycycline. The COVID-19 pandemic might have masked endemic tropical diseases. Clinicians working in endemic regions must always consider common tropical diseases that may present as a co-infection, as in our case. Travel and exposure history are critical guides for narrowing down a differential diagnosis. Early diagnosis and treatment can prevent complications.

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Section: Discussionmentioning

confidence: 99%

Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives

et al. 2023

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“…These may be confirmed by appropriate testing and managed according to local or national guidelines. [ 39 40 ] It must be remembered that a positive result for a non-SARS-CoV-2 pathogen does not rule out COVID-19 nor vice versa.…”

Section: Discussionmentioning

confidence: 99%

Acute management of COVID-19 in the emergency department: An evidence-based review

Abhilash

David

E³

et al. 2022

Journal of Family Medicine and Primary Care

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Coronavirus disease (COVID-19) has been relentlessly battering the world wave after wave in different countries at different rates and times. Emergency departments (EDs) around the globe have had to constantly adapt to this ever-changing influx of information and recommendations by various national and international health agencies. This review compiles the available evidence on the guidelines for triaging, evaluation, and management of critically ill patients with COVID-19 presenting to the ED and in need of emergency resuscitation. The quintessential components of resuscitation focus on airway, breathing, and circulation with good supportive care as the cornerstone of acute management of critically ill COVID-19 patients. Irrational investigations and therapeutics must be avoided during these times of medical uncertainty and antibiotic stewardship should be diligently followed.

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“…Based on overlapping clinical manifestations, it is possible that the occurrence of scrub typhus is overshadowed by COVID-19 in several Asian countries where the disease is endemic, especially in Nepal [ 13 ]. COVID-19 closely mimics other diseases having acute febrile illnesses such as dengue fever, scrub typhus, leptospirosis, and malaria [ 11 , 14 ]. The rapid spread of SARS CoV-2 infections in several tropical countries has resulted in a diagnostic challenge for detecting acute febrile illnesses.…”

Section: Discussionmentioning

confidence: 99%

“…The rapid spread of SARS CoV-2 infections in several tropical countries has resulted in a diagnostic challenge for detecting acute febrile illnesses. To differentiate scrub typhus from COVID-19, clinicians can investigate the presence of eschar, a classic pathognomonic sign, and the most vital indicator for diagnosing scrub typhus [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 and Orientia tsutsugamushi co-infection in a young teen, Nepal: Significant burden in limited-resource countries in Asia?

Bastola

Sah

Rajbhandari

et al. 2021

Narra J

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Scrub typhus is caused by Orientia tsutsugamushi, transmitted through bites of infected chiggers (larval mites). During the coronavirus disease 2019 (COVID-19) pandemic, reports of co-infections with endemic pathogens are increasing around the world. Disease with similar clinical presentation may mask other disease diagnosis and increase the morbidity and mortality of the patients. We report co-infection between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and O. tsutsugamushi in a patient in Nepal presenting with fever, headache, retro-orbital pain, generalized body ache, and knee joints pain with a history of dry cough and dyspnea at night. Since scrub typhus is prevalent and considerate as one of the public health consents in Asian countries and the possible overlapping clinical manifestation with other infections including COVID-19, a further investigation required to determine the burden of SARS-CoV-2 and O. tsutsugamushi co-infection in scrub typhus-endemic countries in Asia.

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Eschar

Cited by 7 publications

References 6 publications

Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives

Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives

Acute management of COVID-19 in the emergency department: An evidence-based review

SARS-CoV-2 and Orientia tsutsugamushi co-infection in a young teen, Nepal: Significant burden in limited-resource countries in Asia?

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