Doctor Bui Trong Hop, from the Infectious Diseases Unit, General Internal Medicine Department, Tam Anh General Hospital, TP HCM, noted Tuan's platelet count had decreased to 83 K/uL. His CRP (inflammation index) rose to 87,2 mg/L, indicating an inflammatory response. Tuan also had an ulcer on his left scrotum, measuring approximately 0,5x0,8 cm, and several painless lymph nodes, 1-2 cm in size, on both sides of his groin.

PCR test results confirmed Tuan had scrub typhus. This infection is caused by the bacterium Orientia tsutsugamushi and is transmitted to humans through the bite of chigger larvae. The skin lesion at the bite site can develop into a characteristic ulcer, even if the patient does not recall being bitten.

Tuan was prescribed broad-spectrum antibiotics to treat Orientia group bacteria. After about five days of treatment, his fever subsided, headache improved, and the ulcer dried, leading to his discharge from the hospital.

Doctor Hop explains the patient's health condition. *Photo: Tam Anh General Hospital*

Scrub typhus begins with a persistent high fever, headache, fatigue, and may include rash and swollen lymph nodes. The initial symptoms are non-specific, making it easy to confuse with dengue fever or other infections.

According to Doctor Hop, chigger bites are often painless and can occur in discreet areas like the groin, genitals, or armpits, making them easy for patients to overlook. If a fever persists without a clear cause, especially after outings, hiking, picnics, or exposure to areas with abundant vegetation and bushes, patients should seek medical examination.

To prevent scrub typhus, doctors recommend limiting direct contact with grass, bushes, and the ground. After returning from at-risk areas, individuals should clean their bodies and clothes, and inspect their skin, especially in private areas and skin folds.

Nhat Thanh

*Patient's name has been changed