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Spontaneous Splenic Rupture Caused by Scrub Typhus

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  • 1 Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
  • | 2 Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
  • | 3 Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Abstract

Spontaneous rupture of the spleen is rarely described as a complication of scrub typhus infection. We report a previously healthy 74-year-old Thai female farmer who presented in Nakhon Ratchasima, Thailand, with a history of fever and malaise for 5 days, followed by abdominal pain for 1 day. An exploratory laparotomy was performed due to peritonitis. Operative findings revealed a ruptured spleen and hemoperitoneum. A splenectomy was performed afterward. Scrub typhus was confirmed by a 4-fold increase of IgM titer using an indirect immunofluorescence antibody assay and a positive result from the polymerase chain reaction targeting the 47- and 56-kDa genes in Orientia tsutsugamushi. She responded well to intravenous chloramphenicol and defervesced within 24 hours without any complication.

Author Notes

* Address correspondence to Wilawan Thipmontree, Department of Medicine, Maharat Nakhon Ratchasima Hospital, 49 Changpuek Road, Amphur Muang, Nakhon Ratchasima 30000, Thailand. E-mail: wthipmontree@gmail.com

Authors' addresses: Wilawan Thipmontree, Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand, E-mail: wthipmontree@gmail.com. Kittipong Suwattanabunpot, Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand, E-mail: kitt.suwa@gmail.com. Yupin Supputtamonkol, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, E-mail: ysuputtamongkol@gmail.com.

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