Case of the Week

Unexplained Fever In a 12-Year-Old Patient Treated By JP Pediatrician

There have been many instances when a patient is suffering from some unknown disease and are referred to JP Hospital, Rourkela for treatment. Since JP Hospital has a well-equipped medical set-up with clinical investigations facilities & presence of specialist consultants for almost every department, many types of illness can be diagnosed and treated here. Recently, in a very similar case, a 12-year-old boy was brought to JP Emergency Department by his parents, with a complaint of a high unexplained fever for the last 10 days. Before coming to JP Hospital, the patient was taken to all the best medical facilities of Bargarh, Sundergarh, Jharsuguda etc. but the fever did not come down, even treated for malaria, typhoid, and dengue empirically.

This patient from Sundergarh, admitted under Dr. Rabi Kumar Senior Pediatrician, had no history of cough, cold or vomiting. But the fever persisted. Initial clinical assessment showed that the patient had eschar – a dry, dark scab or falling away of dead skin, typically caused by a burn, an insect bite, or infection with anthrax – in the left axillary region. Further lab investigation confirmed the clinical suspicion of Dr. Rabi Kumar of Scrub typhus in this patient. Scrub typhus is spread to people through bites of infected chiggers (larval mites). The most common symptoms of scrub typhus include fever, headache, body aches, and sometimes rash. Scrub typhus is a life-threatening infectious disease that presents as an acute undifferentiated febrile illness. Scrub typhus if not treated early may have a mortality rate of up to 30-35 per cent.

This patient was put on oral medications under the watchful eyes of Dr. Rabi Kumar, who assured the parents that their son will recover. Within two days the patient started recovering and the fever subsided, that too without any injection/IV medications. The was discharged on the fifth day in a hemodynamically stable condition.

Dr. Rabi Kumar says “ As of now no vaccine is available to prevent scrub typhus. Reduce your risk of getting scrub typhus by avoiding contact with an infected mite or red bug. When travelling avoid areas with lots of vegetation and brush where mites or bugs may be found.”

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