www.ijbcp.com International Journal of Basic & Clinical Pharmacology | January-February 2016 | Vol 5 | Issue 1 Page 223 IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Case Report A rare clinical case of subdural hemorrhage in a patient with scrub typhus Aradhna Sharma 1 , Tarun Sharma 2 *, Anuradha Sood 3 INTRODUCTION Scrub typhus is a zoonotic vector borne disease caused by a rickettsial organism Orientia tsutsugamushi. 1 This acute febrile illness is endemic in Southeast Asian countries and northern Australian region. 1 The organism is transmitted through the bite of larval forms (chiggers) of trombiculid mites. 2 It may presents either as nonspecific febrile illness with constitutional symptoms such as fever, rash, myalgias and headache or is characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen, and central nervous system. 3-5 Mostly the symptoms are mild and the disease is self-limiting. 1 The recovery is spontaneous within few days in most of the cases. But few cases are more severe and protracted, and the disease may be fatal. 1 The diagnosis of scrub typhus is based on the patient's history of exposure, the clinical features, and the results of serologic testing. 6,7 This case report presents a patient who had subdural hemorrhage during the treatment of scrub typhus while patient’s clinical and laboratory parameters were improving after five days of antibiotic treatment and in whom the effective antibiotic therapy was relatively delayed after the initial onset of symptoms. CASE REPORT A 52 -year-old female was admitted to Regional Hospital, Kullu, Himachal Pradesh, India. The patient belonged to a farmer’s family and daily went to forests to fetch green fodder for the animals at home. She had a history of fever and chills for the last 8 days, along with a four days ABSTRACT Scrub typhus is a common infectious disease with a self-limiting course but may potentially cause a fatal outcome in some cases. We here present a case report of a patient diagnosed with scrub typhus and was given effective antibiotic therapy. Initially, the patient improved significantly but had sudden clinical deterioration on day five and presented with subdural hemorrhage. Orientia tsutsugamushi the causative agent of scrub typhus may be considered as a causal or provoking factor for cerebrovascular accidents in regions where scrub typhus is endemic. Patients should be followed strictly during convalescence in such cases especially in those who have received delayed treatment. Keywords: Scrub typhus, Subdural hematoma DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160133 1 Department of Pharmacology, Pharmacology, Dr. RPGMC Kangra at Tanda, HP, India, 2 Department of Medicine, Regional Hospital, Kullu, HP, India, 3 Department of Microbiology, Dr. RPGMC Kangra at Tanda, HP, India Received: 02 December 2015 Accepted: 07 January 2016 *Correspondence to: Dr. Tarun Sharma, Email: tarun_munna77 @yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.