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Case Reports
. 2021 Apr 13;14(4):e240223.
doi: 10.1136/bcr-2020-240223.

Afebrile scrub typhus infection with cardiac manifestation

Robin George Manappallil  1 , Jayasree Nambiar  2 , Revathy Anil  3
Affiliations
Case Reports

Afebrile scrub typhus infection with cardiac manifestation

Robin George Manappallil et al. BMJ Case Rep. .

Abstract

Scrub typhus is an acute febrile disease transmitted via bites from mite larvae (chigger) infected with Orientia tsutsugamushi. Arrhythmias, ischaemic changes and QT prolongation are some of the observed ECG abnormalities. The patient being reported presented with angina and was found to have sinus bradycardia with ST elevation in inferior leads and T wave inversion in lateral leads. His coronary angiography was normal. Further evaluation leads to the diagnosis of scrub typhus infection. Following doxycycline therapy, his ECG became normal. Afebrile scrub typhus infection with cardiac manifestation is an uncommon scenario.

Keywords: arrhythmias; tropical medicine (infectious disease).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Eschar over inner thigh.
Figure 2
Figure 2
ECG showing sinus bradycardia, ST elevation in leads II, III, aVF and T wave inversion in leads V4–V6.
Figure 3
Figure 3
ECG in sinus rhythm with T wave inversion in leads III, aVF.
See this image and copyright information in PMC

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