Acute Pancreatitis as a Rare Complication of Scrub Typhus: A Case Report

Scrub typhus is transmitted by the bite of chiggers (larvae) of Leptotrombidium deliense and is caused by the bacteria Orientia tsutsugamushi. Common symptoms include fever, headache, lymphadenopathy, and black eschar formation, while acute pancreatitis is a rare complication. We present the case of a 27-year-old gentleman, who presented with epigastric pain and constipation for three weeks, fever for four days, and vomiting for two days. Serum lipase, C-reactive protein, and serum amylase were significantly raised. Enzyme-linked immunosorbent assay anti-scrub typhus IgM was positive at 0.605 optical density. An abdominal computed tomography scan revealed a bulky pancreas. Mild fluid collection (50 x 60 x 65 mm) was seen in the peripancreatic region, along with moderate to gross mesenteric fat stranding. The left anterior and lateral renal conal fascia were thickened and edematous. The patient was managed with intravenous fluids, antipyretics, and intravenous doxycycline.