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Papers of the Week

2021 Jan

J Rural Med



Scrub typhus mimicking the clinical course of infectious mononucleosis: a case report.


Watanabe Y, Mashimo S, Ichige H, Nagata H, Kojima M
J Rural Med. 2021 Jan; 16(1):62-66.
PMID: 33442438.


Scrub typhus is a relatively common life-threating disease; its symptoms are non-specific and similar to those of other viral infections. Therefore, scrub typhus might be underdiagnosed. Herein, we report a patient with scrub typhus whose clinical course mimicked that of infectious mononucleosis. A 63-year-old male patient with hypertension presented to our hospital complaining of symptoms including prolonged fever, pharyngeal discomfort, and a mild headache. He showed the appearance of a rash after amoxicillin administration. At the same time, he did not show a crusted rash on his body surface. After a comprehensive examination, Epstein-Barr virus and cytomegalovirus infections were ruled out. We suspected that this patient suffered from scrub typhus on the basis of his usual lifestyle. Finally, polymerase chain reaction analysis showed a positive result for deoxyribonucleic acid of in his blood sample. Fortunately, he recovered naturally with only supportive treatment during his hospitalization. We should observe and monitor patients with infectious mononucleosis-like symptoms and emphasize the importance of a clinical interview.