Beware of easily overlooked infectious diseases

Information from the Central Hospital for Tropical Diseases, the unit has just received a patient with severe scrub typhus, complications of pneumonia, liver damage and risk of meningitis. It is worth mentioning that the early symptoms of scrub typhus are easily confused with the flu: fever, headache, fatigue, rash... so they are often diagnosed late or missed.

Patient TTK ( Phu Tho ), 81 years old, with a history of type 2 diabetes, started the disease with a continuous high fever of 39-40°C, accompanied by headache, fatigue, and loss of appetite. Scattered rashes appeared on the back, fever responded poorly to antipyretics and common antibiotics. The patient treated himself at home for many days but did not improve.

After 5 days, the patient was taken to a local medical facility for examination. Despite intensive treatment, the patient's condition did not improve, the patient continued to have persistent fever, prolonged headache, impaired perception, nocturnal delirium, and poor appetite. The disease progressed silently but gradually worsened, and on the 9th day, the patient was transferred to the Central Hospital for Tropical Diseases.

Here, doctors discovered a round, black-scaly ulcer in the armpit - a typical but easily overlooked sign of scrub typhus. The rapid test for Orientia Tsutsugamushi IgM antibodies was positive. Tests showed a slight increase in white blood cells and a decrease in platelets, warning of potential sepsis. The patient was treated with specific antibiotics and closely monitored with the diagnosis: severe scrub typhus, complications of pneumonia, liver damage, and risk of meningitis.

Round, black, crusted sores in the armpits – a classic but easily overlooked sign of scrub typhus

According to the family, the patient lives in the countryside, with a garden and fence in front of the house where vegetables are grown and gardening is done regularly. This is an important epidemiological factor, increasing the risk of exposure to parasitic mite larvae on rats, living in low, damp grass around the house.

Dr. Le Van Thieu - Department of General Infections said: "Tick fever is an acute infection caused by Orientia Tsutsugamushi bacteria, transmitted through tick larvae, not adult ticks. Tick larvae parasitize rats, live in bushes, rice fields, and humid areas. When biting people, they leave round, painless, non-itchy ulcers that are easily missed if not examined carefully. Common locations are the armpits, groin, behind the ears, under the breasts, around the navel...".

According to doctors, the early symptoms of scrub typhus are easily confused with the flu: fever, headache, fatigue, rash... so it is often diagnosed late or missed. If not treated promptly with specific antibiotics, the disease can progress rapidly to pneumonia, meningitis, sepsis, liver failure, and be life-threatening, especially in the elderly and people with underlying diseases.

“Sometimes, a forgotten bite is the key to saving a patient. Exploiting epidemiological factors such as gardening, weeding, contact with wet bushes and examining the whole body for ulcers are extremely important to avoid missing the disease,” Dr. Thieu emphasized.

Doctors recommend: “When fever persists for an unknown reason, especially after exposure to bushes, fields and gardens, you should go to a medical facility for examination to rule out tick fever and dangerous infectious diseases. Take the initiative to prevent the disease by wearing long clothes, using insect repellent, clearing bushes, and killing rats, especially during the rainy season - when the disease is likely to break out.”

Source: https://baophapluat.vn/canh-giac-voi-can-benh-truyen-nhiem-de-bi-bo-sot.html