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Case Report
Case report of atypical scrub typhus in pregnancy coexistent with HELLP syndrome mimicking pregnancy specific liver disease (P-sLD): A management dilemma
1 Additional Professor, Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
2 Professor, Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
3 Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
4 Junior Resident, Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
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Sasirekha Rengaraj
Additional Professor, Department of Obstetrics and Gynaecology, Women and Children Block Hospital, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006,
India
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Article ID: 100076Z08SR2021
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How to cite this article
Rengaraj S, Ranjan V, Bharati S, Deodhare KG, Hazarika S. Case report of atypical scrub typhus in pregnancy coexistent with HELLP syndrome mimicking pregnancy specific liver disease (P-sLD): A management dilemma. J Case Rep Images Obstet Gynecol 2021;7:100076Z08SR2021.ABSTRACT
Introduction: Jaundice is one of the most dreaded medical disorders in pregnancy. Infective causes of jaundice are often confused with pregnancy specific liver disorders (P-sLD) like HELLP syndrome and acute fatty liver of pregnancy. Delivery may be needed in some situations irrespective of the etiology.
Case Report: We report a case of preeclampsia (PE) complicated by HELLP syndrome which mimicked thrombotic microangiopathy (TMA) in the postpartum period coexistent with atypical scrub typhus. The diagnostic dilemma at presentation, the challenges surrounding its management, and the recovery following antibiotic treatment with doxycycline are described with a review of the literature.
Conclusion: Infective causes of jaundice in endemic areas cannot be ignored even in straight forward cases of HELLP syndrome especially when it presents as P-sLD.
Keywords: AFLP, HELLP syndrome, Jaundice, P-sLD, Scrub typhus
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Author Contributions
Sasirekha Rengaraj - Acquisition of data, Drafting the article, Final approval of the version to be published
Veena Ranjan - Acquisition of data, Drafting the article, Final approval of the version to be published
Shree Bharati - Substantial contributions to conception and design, Analysis of data, Drafting the article, Final approval of the version to be published
Kirti Girish Deodhare - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sanghamitra Hazarika - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Sasirekha Rengaraj et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
