Scrub Typhus Leading to Acute Liver Failure in a Pregnant Patient

Scrub typhus is a mite-borne rickettsial infection that presents with fever and a diverse array of complications. Lately, many epidemics have been reported from the Indian subcontinent. Data from these outbreaks suggest that liver injury in scrub typhus is common and reversible. We are reporting the case of a 27-year-old pregnant female who presented with fever, encephalopathy, jaundice and seizure. She had acute liver failure and dead fetus on admission. Despite appropriate antibiotics and supportive treatment, she continued to deteriorate and developed multiorgan dysfunction, leading to her demise.

Keywords: acute liver failure; fetal loss; fulminant liver failure; multiorgan dysfunction; orientia tsutsugamushi; outcome; pregnancy; rickettsia; scrub typhus; trombiculid.