Massive splenomegaly in scrub typhus: a rare presentation

We present a diagnostic conundrum of a 22 year old male presenting with fever, hepatomegaly, massive splenomegaly and lymphadenopathy. Tests for malarial parasite, visceral leishmaniasis, enteric fever were negative. Bone marrow aspiration showed normal hemopoeisis. IgM Scrub tested positive. High grade of clinical suspicion and awareness is required among treating physicians for early diagnosis of scrub since delay in treatment initiation may lead to a dismal clinical outcome.
Source: IDCases - Category: Infectious Diseases Source Type: research