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Tropical pyomyositis in scrub typhus: a rare association
  1. Atanu Chandra1,
  2. Aritra Kumar Ray1,
  3. Arkapravo Hati1 and
  4. Uddalak Chakraborty2
  1. 1Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
  2. 2Neurology, Institute of Postgraduate Medical Education and Research Bangur Institute of Neurology, Kolkata, India
  1. Correspondence to Dr Atanu Chandra; chandraatanu123{at}gmail.com

Abstract

Tropical pyomyositis manifests as single or multiple abscesses inside skeletal muscles and it has a higher prevalence in immunocompromised patients. Scrub typhus, a zoonotic disease is caused by Orientia tsutsugamushi and the clinical manifestations range from simple febrile illness to organ threatening complications. Here, we present a rare case of an immunocompetent young man diagnosed as tropical pyomyositis in association with scrub typhus. Imaging of both thighs revealed multiple intramuscular abscesses. Blood and aspirated pus were culture negative. Patient was treated aggressively with parenteral antibiotics (linezolid, clindamycin and meropenem) and surgical debridement. But, fever did not subside and total leucocyte count remained persistently high. After serological confirmation of scrub typhus, the patient was put on oral doxycycline and he had a dramatic improvement within next few days. To the best of our knowledge, this is probably the first reported case of tropical pyomyositis in association with scrub typhus.

  • tropical medicine (infectious disease)
  • general practice / family medicine
  • infectious diseases

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Footnotes

  • Contributors AC and UC contributed to conception, initial drafting of manuscript, critical revision of content and final approval of manuscript. AKR, AH and AC contributed to patient management, conception, critical revision of content and final approval of manuscript. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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