Yyhh

1. Case presentation on
SCRUB TYPHUS
Under the guidance of
Practice school BP706P
Presented by
BIJAY BHATTRAI
ROLL NO : 20GPC012

2. Brief Summary Of Case
• A 11 years old female patient of bearing Admission no 12345 was
admitted in the department of pediatrics ward on 10/08/23 And got
discharged on 17/8/23
• chief compliant of
. Fever * 3days
. Breathing difficulty and vomiting
. Swelling of the face and lower limbs

3. PAST MEDICAL HISTORY
• No history of similar complaint in past
• Not know hypertensive ,diabetes mellitus ,TB patient
• SOCIAL HISTORY:
• Not alcoholic
• Not smoker

4. • ON EXAMINATION :
Patient is conscious coherent
VITALS:
DATE PLUS RATE
MORING
BP MORING TEMPARATURE SPO2
10/08/23 63bpm 91/52mm of hg 102 f 91%
11/08/23 75bpm 110/60mm of hg 100.8 f 93%
12/08/23 70bpm 108/58mm of hg 100.1 f 96%
13/08/23 73bpm 112/70mm of hg 99.8 f 98%
14/08/23 70bpm 100/65mm of hg 100.2 f 97%
15/08/23 80bpm 106/60mm of hg 97.9 f 92%
16/08/23 76bpm 100/65mm of hg 97.1 f 93%
17/08/23 70bpm 101/58mm of hg 98.1 96%

5. LABORATORY INVESTIGATIONS :
LIPID PROFILE TEST:
S.no parameter Observed value Normal value
1 WBC 7.77 [10^3/uL] 4.00-11.0
2 RBC 4.33 [10^3/uL] 2.50-5.50
3 HGB 12.9 [g/dl] 10.0-17.0
4 MCV 88.2 [ft] 78.0-98.0
5 MCH 29.8 [pg] 26.0-36.0
6 MCHC 33.8 [g/dl] 32.0-35.0
7 PLT 230 [10^3/uL] 150-450
8 NEUT 4.57-[10^3/uL] 79.2+ % 37.0-72.0
10 LYMPH 0.95 –[10^3/uL] 16.5-% 20.0-50.0
11 MONO 0.20[10^3/uL] 3.5% 0.0-11.0
12 EO 0.02[10^3/uL] 0.3% 0.0-6.0
13 BASO 0.03[10^3/uL] 0.5% 0.0-1.0
14 IG 0.01[10^3/uL] 0.2%

6. LFT AND KFT REPORT
PARAMETER OBSERVE VALUE NORMAL RANGE REMARKS
UREA 36 mg/dl 13-45mg/dl
Serum creatinine 0.5mg/dl 0.6-1.1 mg/dl
AST/GOT 50 u/l 0-31u/l
ALT GPT 65 mg/dl 0-34 u/l
BILIRUBIN DIRECT 0.34 mg/dl 0.00-0.40 mg/dl
BILIRUBIN TOTAL 0.68 mg/dl 0.00-2.00 mg/dl
TOTAL PROTEIN 4.5g/dl 6.4 -8.3 g/dl
ALBUMIN 2.4g/dl 3.2 -5.2g/dl
ALP 208 u/l 53-128 u/l

7. • URINE TEST REPORT : Sterile after overnight incubation at 37 c
(aerobic)
• BLOOD TEST REPORT : Sterile after 48hrs of incubation at 37 c
(aerobic)
• Rapid ICT For O.Tsutsugamushi : positive
DIAGNOSIS:
On observing chief complaint, laboratory reports like
blood test , urine test , LFT, KFT ,CBC and rapid ICT for O.
TSUTSUGAMUSHI TEST , the disease was diagnosed as SCRUB TYPHUS.

8. DEFINATION:
• Also know as japanese river fever , tsutsugamushi in japanese means
tsutsuga =disease ,mushi = bug.
• It is a disease caused by bacteria called orientia tsutsugamushi . Scrub typhus
is spread to people through bites of infected chiggers ( larva mites) larval
stages normally feed on rodents , human are accidental hosts.
• The most common symptoms of scrub typhus include
Fever and headache
nausea and vomiting
body aches sometimes rash
diarrhea , constipation , conjunctival suffusion

10. DRUG CHART
SL NO. BRAND NAME GENERIC NAME DOSE CLASSIFICATION FREQ.
1 INJ . ceftriaxone INJ. TRAXOL 1g antibiotics BD
2 Tab. Lasix 20 fruesemide 20mg Loop diruetic OD
3 Tab P 250 Paracetamol 250mg Analgesic and
antipyretic
sos
4 Tab doxylin-100
LB
Doxycyclin and
lactic acid bacillus
100mg Antibiotics BD
4 TAB. Onden MD Ondansetron 4mg antiemetics SOS
5 IVF DNS 500ml
DAY of treatment
7 days
4 days
4 days
7 days
2 days
1 day

11. PHARMACIST INTERVENTION
• The patient was informed about the administration of drugs as per the
prescription.
• The patient was educated about the side effect and dosage of drugs
prescribed.
• Doxycyclin

12. CONCLUSION
A 11 years old female patient was admitted to the Sochakgang
Multispecialty Hospital pediatrics ward on 10/08/23 with the chief
complaint of . Fever * 3days Breathing difficulty and vomiting Swelling
of the face and lower limbs After undergoing investigations (CBC , LFT
,KFT, URINE TEST AND Rapid ICT For O.Tsutsugamushi patients was
diagnosed with SCRUB TYPHUS
• And prescribed a drug such as INJ. traxol ,frusemide ,Paracetamol
Doxycyclin and lactic acid bacillus ,Ondansetron and patient was
found to be stable and discharged on 17/08/23.