Indian tick typhus presenting as Purpura fulminans.

Abstract

Seriously ill patients presenting with purpura fulminans, sepsis and multi-organ failure often require extensive diagnostic workup for proper diagnosis and management. Host of common infections prevalent in the tropics, e.g. malaria, dengue; other septicemic infections e.g. meningococcemia, typhoid, leptospirosis, toxic shock syndrome, scarlet fever, viral exanthems like measles, infectious mononucleosis, collagen vascular diseases (Kawasaki disease, other vasculitis) diseases, and adverse drug reactions are often kept in mind, and the index of suspicion for rickettsial illness is quite low. We present a case of Indian tick typhus presenting with purpura fulminans (retiform purpura all over the body), sepsis and multiorgan failure without lymphadenopathy and eschar, successfully treated with doxycycline and discharged home. Hence, a high index clinical suspicion and prompt administration of a simple therapy has led to successful recovery of the patient.

• Authors: Suhasini Tirumala, Bijayini Behera, Srikanth Jawalkar, Pradeep Kumar Mishra, Pavithra Vani Patalay, Sudha Ayyagari, Pavani Nimmala
• Journal: Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine (Indian J Crit Care Med) Vol. 18 Issue 7 Pg. 476-8 (Jul 2014) ISSN: 0972-5229 [Print] India
• PMID: 25097365 (Publication Type: Case Reports)