A case of pulmonary tuberculosis patient complicated with hemorrhagic fever with renal syndrome and scrub typhus in Yunnan, China: a case report

Abstract

Abstract Background Hemorrhagic fever with renal syndrome (HFRS) caused by Orthohantavirus (OHV) and scrub typhus (ST) caused by Orientia tsutsugamushi (OT) are two infectious diseases prevalent in southwest China. Rodents are the natural host and the main source of the two diseases. OT infection to humans is usually resulted from bite of an infective chigger mite on rodents, and OHV is transmitted through contact or inhalation of aerosols and secretions from infected rodent. For infectious diseases, the use of antibiotics and hormones is essential, so the diagnosis of complex situations is not easy under the action of drugs. Clinically, fever is the first symptom of these two diseases, and most of them are accompanied by common symptoms such as chills and headaches. The clinical symptoms of these two diseases are very similar, so it is easy to diagnose and miss diagnosis. Case presentation: In this case, a 44-year-old male famer with a history of working in coal transportation was admitted to the hospital because of respiratory symptoms accompanied by fever, headache, and skin rashes on his body. Biochemical and urinalysis revealed the hepatic and renal injury. The subsequent molecular testing confirmed he suffered from HFRS and scrub typhus simultaneously that the serological and clinical diagnosis could not identify the cause of infection before. Such case has not been reported in Yunnan Province before. Conclusion As the clinical findings of HFRS and scrub typhus are similar and usually unspecific, the clinical diagnosis should be made with a combination of serological and etiological approaches. In the endemic areas of the two diseases, potential HFRS and ST patients should be precisely distinguished with more tests, which is critical for developing proper treatment plans.