Imagine stumbling upon a medical mystery where a teenager's lungs fill with fluid out of nowhere, all from a bite that's barely noticeable—sounds like something from a thriller, right? Well, that's exactly the shocking case we're diving into today, where scrub typhus led to acute pulmonary edema without any heart or kidney issues. Stick around; this rare twist on a common disease might just change how you think about infections in tropical areas. And here's where it gets controversial—could this mean we're overlooking subtle lung problems in everyday cases? Let's explore this unusual scenario step by step, breaking down the science in simple terms so anyone can follow along.
Acute Pulmonary Edema Complicating Scrub Typhus: An Unusual Occurrence Despite Intact Heart and Kidney Health
- Case Study
- Freely Accessible (https://www.springernature.com/gp/open-science/about/the-fundamentals-of-open-access-and-open-research)
Released: November 11, 2025
Kajananan Sivagurunathan¹,
Nishadi Perera¹ &
Anuranga Senanayake¹
BMC Infectious Diseases (https://bmcinfectdis.biomedcentral.com/) edition 25, Article 1541 (2025) Reference this paper
Abstract
Introduction
Scrub typhus, a rickettsial ailment spread by mite bites, is widespread in parts of Asia, including Sri Lanka, and shows up in many different ways symptom-wise.
Patient Details
This report describes an extraordinary instance of a 16-year-old boy who arrived with a week-long fever that worsened into low oxygen levels and congested lungs. Physical checks uncovered an eschar and swollen groin lymph nodes, strongly hinting at scrub typhus, later backed by a Weil-Felix OXK antibody level of 1:1280. Initially, myocarditis was suspected, but heart and kidney functions were perfectly fine, and he bounced back quickly on doxycycline and a small dose of frusemide. The progression, lack of organ damage, and swift imaging improvement pointed to non-cardiogenic pulmonary edema. Acute respiratory distress syndrome (ARDS) seemed improbable and was dismissed.
Summary
This report underscores scrub typhus as an uncommon trigger for pulmonary edema that happens without heart or kidney problems, stressing the importance of vigilance in affected areas.
Trial Registration
Not relevant.
Peer Evaluation Documents (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9/peer-review)
Introduction
Scrub typhus, triggered by the bacterium Orientia tsutsugamushi, is a rickettsial disease carried by larval trombiculid mites, often called chiggers. It's prevalent in the Asia-Pacific region, Sri Lanka included [1 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR1) , 2 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR2) ]. Researchers in northern Sri Lanka found that 84.4% of those with rickettsial-like symptoms tested positive for scrub typhus, many featuring the telltale eschar [3 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR3) ]. The illness can range from silent infections to severe cases with multiple organ failures, shock, or even death [4 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR4) ]. Lung complications in scrub typhus are well-documented, such as pleural fluid buildup, pneumonia, interstitial lung issues, or ARDS [5 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR5) ]. Typically, heart problems are linked to pulmonary edema in this disease [6 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR6) ]. Yet, acute lung fluid buildup without any heart or kidney disruption is incredibly uncommon.
We share the story of a healthy young male teenager who developed acute pulmonary edema from scrub typhus, with no signs of myocarditis or kidney trouble. This highlights the value of spotting unusual breathing issues early in areas where the disease is common.
Patient Narrative
A 16-year-old male was brought to our District General Hospital for care after enduring a seven-day fever that led to breathing difficulties. His symptoms kicked off with a persistent high fever, chills, shivering, headaches, and body aches. There were no specific signs like coughing up mucus, bladder issues, or diarrhea. He visited a clinic on day two, but things didn't improve. By day five, his fever lingered, and he lost his appetite, vomited, and drank less, leading to hospital admission. There, he was prescribed 625mg of co-amoxiclav orally three times a day.
On his sixth day in the local hospital, he had a slightly low blood pressure of 88/56 mmHg and got a IV saline push, which raised it to 98/60 mmHg. Despite the dip, his average blood pressure stayed above 65 mmHg, with warm limbs and enough urine, meaning he wasn't in shock. But that night, he struggled to breathe with a blood oxygen of 88%, so he was transferred to us. Upon arrival, he looked unwell, breathing at 24 times per minute and oxygenating at 89% on air. Lung sounds revealed a few crackles in both lower areas, but no raised neck veins or swollen ankles. His stats were mostly stable: blood pressure 102/60 mmHg, pulse 134 beats per minute. A thorough check spotted an eschar on his right buttock, pointing to scrub typhus (Fig. 1 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#Fig1) ). He also had swollen lymph nodes in the right groin, reinforcing the diagnosis. No enlarged liver or spleen was noted. He was immediately given 200mg of doxycycline orally.
Because of his breathing troubles, we first considered myocarditis causing cardiogenic pulmonary edema or direct lung infection from scrub typhus. A bedside lung ultrasound showed mild fluid around both lungs and signs of interstitial changes, but no solid areas. The emergency team's bedside heart scan indicated slight overall weakness, while his ECG showed fast heart rate but no strange waves or rhythms (Fig. 2 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#Fig2) ). His chest X-ray displayed upward-shifted lung vessels and congested central areas resembling a bat's wings, typical of edema (Fig. 3 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#Fig3) A). Blood gas test on room air: pH 7.5, CO2 27.2 mmHg, oxygen 57 mmHg, bicarbonate 21 mmol/L, giving a PaO₂/FiO₂ of 271.4. We suspected myocarditis-related lung edema and gave oxygen via mask and 20mg IV frusemide. Within three hours, his breathing eased, oxygen jumped to 96% on air, rate dropped to 18, and pulse to 102. But a proper heart scan later showed normal left heart function and fine troponin levels, ruling out cardiogenic causes. No kidney issues either, with good urine and normal creatinine. BNP wasn't checked, but the evidence leaned toward non-cardiogenic edema from capillary leakage. His blood results are in Table 1 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#Tab1) .
Eschar on the patient's right buttock with accidental scab removal, acting as a crucial clue for scrub typhus diagnosis
Full size image (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9/figures/1)
Full size table (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9/tables/1)
ECG displaying sinus tachycardia without irregular T or ST segments or abnormal rhythms
Full size image (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9/figures/2)
Patient's successive chest X-rays. (A) Original scan showing elevated lung vessels, central congestion like bat wings, indicating edema. (B) Scan after 48 hours showing clear improvement
Full size image (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9/figures/3)
His diuretic treatment lasted 48 hours before stopping. Doxycycline continued at 200mg every 12 hours for 48 hours, then 100mg every 12 hours for eight more days. He was watched in ICU for 24 hours, then moved to the ward. Fever gone by 36 hours in. A follow-up X-ray after 48 hours on diuretics showed big improvements (Fig. 3 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#Fig3) B). He recovered fully and went home stable. The Weil-Felix result came two weeks later: OXK titer 1:1280, confirming scrub typhus.
Analysis
Orientia tsutsugamushi is a gram-negative bacterium inside cells, spread by infected chigger larvae from Leptotrombidium mites [2 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR2) ]. After a bite, it multiplies locally, forming a sore that turns into a scabbed eschar. Eschar is one of the first and most distinctive signs of scrub typhus. Even though it's a strong clue, it's painless and often hidden in spots like the groin, armpits, or buttocks, making it easy to miss, especially in people with darker skin [2 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR2) ]. In Sri Lanka's endemic zones, spotting an eschar is key for quick diagnosis, as seen here. It usually comes with nearby swollen nodes, which can spread to all nodes soon after [7 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR7) ]. Symptoms appear 8-10 days post-bite, with germs in the blood just before fever starts [8 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR8) ]. Like other rickettsial diseases, it causes inflammation around small vessels. Though it affects blood vessel linings, studies show immune cells called macrophages are involved [9 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR9) ]. Scrub typhus spreads to various organs via macrophages and shed cells in the bloodstream, leading to deadly issues [7 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR7) ].
Lung issues in scrub typhus are well-known. Causes might include direct vessel damage, immune reactions, and body-wide inflammation. But edema without heart or kidney problems is rare. In this case, the initial worry about myocarditis from mild weakness on bedside scan was dispelled by a full heart ultrasound showing intact function and normal troponin. The scan differences likely stemmed from bedside limits, not real issues. BNP, useful for distinguishing edema types, wasn't tested—admitting that's a gap. Still, normal heart scans and troponin, plus good urine and creatinine, ruled out heart failure. Kidney overload wasn't a factor either. The full picture—eschar, lab confirmation, both lungs affected, no other organ troubles—pointed to scrub typhus-caused non-cardiogenic edema from leaky capillaries.
Fluid overload was considered but unlikely. He got just one saline boost, stabilizing blood pressure. No signs of excess fluid like raised veins, swollen legs, or low urine, and kidneys stayed fine. One saline isn't enough for major edema needing oxygen.
ARDS is the top non-cardiogenic edema cause; telling it apart can be tricky. ARDS shows sudden low oxygen, patchy lung images, no heart failure, often needing vents. Here, though congestion showed on X-ray and oxygen was low, the course and quick diuretic response suggested something else. ARDS usually takes days and reacts slowly. Per Berlin criteria, it needs acute onset, bilateral spots, failure not from heart/fluid, and low oxygenation at PaO₂/FiO₂ ≤300 with 5cm H₂O PEEP/CPAP. His ratio was 271.4 on air, so no ARDS.
Some literature mentions edema in scrub typhus. Zhou et al. described a 35-year-old man with week-long fevers, rash, belly pain, and peritonitis [10 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR10) ]. He soon got widespread inflammation and lung edema needing vents. Unlike ours, he had multi-organ issues, including possible myocarditis (troponin up, no echo done), and peritonitis. So, our case stands alone as scrub typhus non-cardiogenic edema without other failures.
Interestingly, his breathing improved fast with low-dose IV frusemide. Capillary leak edema is non-cardiogenic and often doesn't respond to diuretics, but this shows they might help symptomatically in stable patients with congestion. Careful low-dose use could drain extra lung fluid without hurting blood volume. His quick recovery backs this. A review notes diuretics might aid stable non-cardiogenic cases [11 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR11) ], though not scrub typhus-specific, covering all leak syndromes.
Early treatment is key for scrub typhus. Doxycycline is first-line, very effective [12 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR12) ]. Following UpToDate and local rules, severe cases get 200mg twice daily for 48 hours, then normal [13 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR13) ]. He was severe but got oral doxycycline (IV unavailable); its good absorption and success make it ideal here. Azithromycin is backup, good for doxycycline-contraindicated folks like pregnant women or kids [14 (https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-12008-9#ref-CR14) ]. He responded well, much better by 48 hours.
Conclusion
This story shows we need to suspect scrub typhus in fever-plus-breathing cases, especially in endemic spots. Even if edema is rare, it can happen without heart or kidney problems. It emphasizes spotting it early and starting doxycycline fast, even in weird presentations, to avoid bad outcomes. Plus, low-dose diuretics might ease symptoms in stable non-ARDS non-cardiogenic edema.
Data Access
Details came from the patient's hospital records at District General Hospital Kilinochchi, Sri Lanka. No private info is shared. Data available from the main author with ethical approval.
Shortcuts
ARDS:
Acute respiratory distress syndrome
References
1.
Kelly DJ, Fuerst PA, Ching WM, Richards AL. Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi. Clin Infect Dis. 2009;48(Suppl 3):S203–30. https://doi.org/10.1086/596576
Article (https://doi.org/10.1086%2F596576) CAS (https://bmcinfectdis.biomedcentral.com/articles/cas-redirect/1:CAS:528:DC%2BD1MXktVyku7o%3D) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=19220144) Google Scholar (http://scholar.google.com/scholarlookup?&title=Scrub%20typhus%3A%20the%20geographic%20distribution%20of%20phenotypic%20and%20genotypic%20variants%20of&journal=Clin%20Infect%20Dis&doi=10.1086%2F596576&volume=48&issue=Suppl%203&pages=S203-30&publication_year=2009&author=Kelly%2CDJ&author=Fuerst%2CPA&author=Ching%2CWM&author=Richards%2CAL)
2.
Centers for Disease Control and Prevention. Clinical overview of scrub typhus. 2024. Available from: https://www.cdc.gov/typhus/hcp/clinical-overview/clinical-overview-of-scrub-typhus.html [Accessed 25 Apr 2025].
3.
Pradeepan JA, Ketheesan N, Murugananthan K. Emerging scrub typhus infection in the Northern region of Sri Lanka. BMC Res Notes. 2014;7:719. https://doi.org/10.1186/1756-0500-7-719.
Article (https://link.springer.com/doi/10.1186/1756-0500-7-719) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=25316171) PubMed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216347) Google Scholar (http://scholar.google.com/scholarlookup?&title=Emerging%20scrub%20typhus%20infection%20in%20the%20Northern%20region%20of%20Sri%20Lanka&journal=BMC%20Res%20Notes&doi=10.1186%2F1756-0500-7-719&volume=7&publication_year=2014&author=Pradeepan%2CJA&author=Ketheesan%2CN&author=Murugananthan%2CK)
4.
Devamani C, Alexander N, Chandramohan D, et al. Incidence of scrub typhus in rural South India. N Engl J Med. 2025;392:1089–99. https://doi.org/10.1056/nejmoa2408645.
Article (https://doi.org/10.1056%2Fnejmoa2408645) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=40073309) PubMed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617504) Google Scholar (http://scholar.google.com/scholarlookup?&title=Incidence%20of%20scrub%20typhus%20in%20rural%20South%20India&journal=N%20Engl%20J%20Med&doi=10.1056%2Fnejmoa2408645&volume=392&pages=1089-99&publication_year=2025&author=Devamani%2CC&author=Alexander%2CN&author=Chandramohan%2CD)
5.
Wiwanitkit S, Wiwanitkit V. Pleuropulmonary scrub typhus: a summary of Thai cases. J Vector Borne Dis. 2012;49:48.
Article (https://doi.org/10.4103%2F0972-9062.213329) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=22585246) Google Scholar (http://scholar.google.com/scholarlookup?&title=Pleuropulmonary%20scrub%20typhus%3A%20a%20summary%20of%20Thai%20cases&journal=J%20Vector%20Borne%20Dis&doi=10.4103%2F0972-9062.213329&volume=49&publication_year=2012&author=Wiwanitkit%2CS&author=Wiwanitkit%2CV)
6.
Lin SY, Matsuno Y, Yokosawa M, et al. Analysis of scrub typhus involvement of the lung by Bronchoalveolar lavage: a case report. Respir Investig. 2016;54:487–9. https://doi.org/10.1016/j.resinv.2016.06.004.
Article (https://doi.org/10.1016%2Fj.resinv.2016.06.004) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=27886863) Google Scholar (http://scholar.google.com/scholarlookup?&title=Analysis%20of%20scrub%20typhus%20involvement%20of%20the%20lung%20by%20Bronchoalveolar%20lavage%3A%%a%20case%20report&journal=Respir%20Investig&doi=10.1016%2Fj.resinv.2016.06.004&volume=54&pages=487-9&publication_year=2016&author=Lin%2CSY&author=Matsuno%2CY&author=Yokosawa%2CM)
7.
Medscape. Scrub typhus. 2023. Available from: https://emedicine.medscape.com/article/971797-overview#a4 [Accessed 25 Apr 2025].
8.
Shirai A, Saunders JP, Dohany AL, Huxsoll DL, Groves MG. Transmission of scrub typhus to human volunteers by laboratory-reared chiggers. Jpn J Med Sci Biol. 1982;35:9–16. https://doi.org/10.7883/yoken1952.35.9.
Article (https://doi.org/10.7883%2Fyoken1952.35.9) CAS (https://bmcinfectdis.biomedcentral.com/articles/cas-redirect/1:STN:280:DyaL383kt1ymtw%3D%3D) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=6808205) Google Scholar (http://scholar.google.com/scholarlookup?&title=Transmission%20of%20scrub%20typhus%20to%20human%20volunteers%20by%20laboratory-reared%20chiggers&journal=Jpn%20J%20Med%20Sci%20Biol&doi=10.7883%2Fyoken1952.35.9&volume=35&pages=9-16&publication_year=1982&author=Shirai%2CA&author=Saunders%2CJP&author=Dohany%2CAL&author=Huxsoll%2CDL&author=Groves%2CMG)
9.
Suputtamongkol Y, Suttinont C, Niwatayakul K, et al. Epidemiology and clinical aspects of rickettsioses in Thailand. Ann N Y Acad Sci. 2009;1166:172–9. https://doi.org/10.1111/j.1749-6632.2009.04514.x.
Article (https://doi.org/10.1111%2Fj.1749-6632.2009.04514.x) CAS (https://bmcinfectdis.biomedcentral.com/articles/cas-redirect/1:STN:280:DC%2BD1Mvjt1ejuw%3D%3D) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=19538278) Google Scholar (http://scholar.google.com/scholarlookup?&title=Epidemiology%20and%20clinical%20aspects%20of%20rickettsioses%20in%20Thailand&journal=Ann%20N%20Y%20Acad%20Sci&doi=10.1111%2Fj.1749-6632.2009.04514.x&volume=1166&pages=172-9&publication_year=2009&author=Suputtamongkol%2CY&author=Suttinont%2CC&author=Niwatayakul%2CK)
10.
Zhou XL, Ye QL, Chen JQ, Li W, Dong HJ. Manifestation of acute peritonitis and pneumonedema in scrub typhus without eschar: a case report. World J Clin Cases. 2021;9:6900–6. https://doi.org/10.12998/wjcc.v9.i23.6900
Article (https://doi.org/10.12998%2Fwjcc.v9.i23.6900) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=34447840) PubMed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362526) Google Scholar (http://scholar.google.com/scholarlookup?&title=Manifestation%20of%20acute%20peritonitis%20and%20Pneumonedema%20in%20scrub%20typhus%20without%20eschar%3A%20a%20case%20report&journal=World%20J%20Clin%20Cases&doi=10.12998%2Fwjcc.v9.i23.6900&volume=9&pages=6900-6&publication_year=2021&author=Zhou%2CXL&author=Ye%2CQL&author=Chen%2CJQ&author=Li%2CW&author=Dong%2CHJ)
11.
Siddall E, Khatri M, Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and management. Kidney Int. 2017;92(1):37–46. https://doi.org/10.1016/j.kint.2016.11.029.
Article (https://doi.org/10.1016%2Fj.kint.2016.11.029) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=28318633) Google Scholar (http://scholar.google.com/scholarlookup?&title=Capillary%20leak%20syndrome%3A%20etiologies%2C%20pathophysiology%2C%20and%20management&journal=Kidney%20Int&doi=10.1016%2Fj.kint.2016.11.029&volume=92&issue=1&pages=37-46&publication_year=2017&author=Siddall%2CE&author=Khatri%2CM&author=Radhakrishnan%2CJ)
12.
Song JH, Lee C, Chang WH, et al. Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial. Clin Infect Dis. 1995;21:506–10. https://doi.org/10.1093/clinids/21.3.506
Article (https://doi.org/10.1093%2Fclinids%2F21.3.506) CAS (https://bmcinfectdis.biomedcentral.com/articles/cas-redirect/1:CAS:528:DyaK2MXosl2qt74%3D) PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&listuids=8527534) Google Scholar (http://scholar.google.com/scholarlookup?&title=Short-course%20Doxycycline%20treatment%20versus%20conventional%20Tetracycline%20therapy%20for%20scrub%20typhus%3A%20a%20multicenter%20randomized%20trial&journal=Clin%20Infect%20Dis&doi=10.1093%2Fclinids%2F21.3.506&volume=21&pages=506-10&publication_year=1995&author=Song%2CJH&author=Lee%2CC&author=Chang%2CWH)
13.
UpToDate. Scrub typhus. 2025. Available from: https://www.uptodate.com/contents/scrub-typhus [Accessed 20 Aug 2025].
14.
Kim YS, Lee HJ, Chang M, Son SK, Rhee YE, Shim SK. Scrub typhus during pregnancy and its treatment: a case series and review of the literature. Clin Infect Dis. 2006;42:955–9. https://doi.org/10.4269/ajtmh.2006.75.955.
Article (https://doi.org/10.4269%2Fajtmh.2006.75.955) Google Scholar (http://scholar.google.com/scholarlookup?&title=Scrub%20typhus%20during%20pregnancy%20and%20its%20treatment%3A%20a%20case%20series%20and%20review%20of%20the%20literature&journal=Clin%20Infect%20Dis&doi=10.4269%2Fajtmh.2006.75.955&volume=42&pages=955-9&publicationyear=2006&author=Kim%2CYS&author=Lee%2CHJ&author=Chang%2CM&author=Son%2CSK&author=Rhee%2CYE&author=Shim%2CSK)
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Author Details
Authors and Locations
1.
District General Hospital Kilinochchi, Kilinochchi, Sri Lanka
Kajananan Sivagurunathan,Nishadi Perera&Anuranga Senanayake
Contributors
- Kajananan Sivagurunathan
- Nishadi Perera
- Anuranga Senanayake
Roles
KS handled much of the patient care, idea and planning, data gathering, review, and writing/editing. NP did similar for care, planning, data, and writing. AS contributed to care, planning, data, and writing. All okayed the final draft and take responsibility.
Main Contact
Correspondence to Kajananan Sivagurunathan.
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Cite this article
Sivagurunathan, K., Perera, N. & Senanayake, A. A case of acute pulmonary edema in scrub typhus: a rare complication with normal cardiac and renal function. BMC Infect Dis 25, 1541 (2025). https://doi.org/10.1186/s12879-025-12008-9
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Received: 17 June 2025
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Accepted: 20 October 2025
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Published: 11 November 2025
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Version: 11 November 2025
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DOI: https://doi.org/10.1186/s12879-025-12008-9
Topics
But wait, this is the part most people miss—does using diuretics in non-cardiogenic edema really challenge standard protocols, or is it a hidden tool we should explore more? And here's another controversial angle: with cases like this popping up, are we underestimating scrub typhus in global health priorities? What do you think—should routine screenings change, or is this just an outlier? Share your thoughts in the comments; I'd love to hear if you've seen similar cases or if this shifts your view on tropical infections!
