Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness. Characteristics of tsutsugamushi disease are fever, rash and eschar. However, severe complications might rarely occur, such as acute fulminant myocarditis caused by scrub typhus. Thus, there are few reports of recovery from seriously complicated cases. We report on an adult male with scrub typhus complicated with acute fulminant myocarditis with no previous comorbid illness who recovered successfully with proper treatment including antibiotics, ventilator support, percutaneous cardiopulmonary support, and continuous renal replacement therapy.

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• Comprehensive review on cardiac manifestation of scrub typhus
  Barath Prashanth Sivasubramanian, Abul Hasan Shadali Abdul Khader, Diviya Bharathi Ravikumar, Francis Vino Dominic Savio, Umabalan Thirupathy, Varshini Thiruvadi, Rhea Prasad, Hema Thokala, Husna Qadeer, Dhiraj Poragal Venkataperumal, Ashima Gupta, Nagara
  Frontiers in Tropical Diseases.2024;[Epub]     CrossRef
• Case Report: Fulminant Myocarditis Successfully Treated With Extracorporeal Membrane Oxygenation in Ikeda Strain Orientia tsutsugamushi Infection
  Hyejin Park, Yongwhan Lim, Min Chul Kim, Seong Eun Kim, In-Seok Jeong, Yoo Duk Choi, Dong-Min Kim
  Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
• A case report of scrub typhus complicated with myocarditis and rhabdomyolysis
  Young-Jae Ki, Dong-Min Kim, Na-Ra Yoon, Sung-Soo Kim, Choon-Mee Kim
  BMC Infectious Diseases.2018;[Epub]     CrossRef

A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.