Renal abscess: a rare complication of scrub typhus associated with multiorgan failure

Background: Scrub typhus is endemic in the various parts of the world and especially in the Indian subcontinent. renal abscess are largely unknown in scrub typhus. These can be a source of persistent abdominal pain. Clinical Description: A 38-year-old male presented with a 4-day history of fever, loose stools, respiratory distress, and abdominal pain. On examination, he was febrile, had tachypnea, tachycardia, and facial puffiness. Acute febrile illness to differentials of tropical infections (dengue, scrub typhus, enteric fever, and malaria). Management: Dengue, enteric fever, and malaria were ruled out on investigations. Scrub IgM enzyme-linked immunosorbent assay was positive. Ultrasound of the abdomen showed renal anechoic lesions suggestive of abscess. Contrast-enhanced computed tomography (CT) confirmed the findings. Blood and urine culture was sterile The final diagnosis was scrub typhus with renal abscess. His symptoms resolved with doxycycline therapy. Conclusion: Involvement of the renal abscess is a rare complication in scrub typhus and can lead to persisting abdominal symptoms. Renal abscess is not a well-known complication in patients of scrub typhus; hence, it may lead to under diagnosis of the condition. An abdominal ultrasound or if required, CT scan of the abdomen might be needed in cases with persistent abdominal symptoms to rule out this rare complication.