Acute respiratory distress syndrome complicating scrub typhus in pregnancy

Scrub typhus is caused by Orientia tsutsugamushi (formerly Rickettsia) and is transmitted to humans by an arthropod vector of the Trombiculidae family. Recent reports suggest that there has been resurgence of rickettsial infections in the Indian subcontinent. As the clinical features of scrub typhus are nonspecific and closely mimic that of other tropical infections, its diagnosis is often delayed or missed. It may cause serious complications such as myocarditis, meningoencephalitis, acute renal failure, acute liver failure, pneumonia, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation, and multiorgan dysfunction syndrome. Early diagnosis is important because the response to treatment is excellent and may help prevent complications. Here, we report a case of scrub typhus in a pregnant woman complicated by ARDS; however, timely diagnosis and institution of therapy helped save two precious lives.