PT - JOURNAL ARTICLE AU - Meenupriya Arasu AU - Nagalakshmi Swaminathan AU - Anusha Cherian AU - Magesh Parthiban TI - Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome AID - 10.1136/bcr-2021-242870 DP - 2021 Apr 01 TA - BMJ Case Reports PG - e242870 VI - 14 IP - 4 4099 - http://casereports.bmj.com/content/14/4/e242870.short 4100 - http://casereports.bmj.com/content/14/4/e242870.full SO - BMJ Case Reports2021 Apr 01; 14 AB - A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.