Acalculous Cholecystitis in a Young Adult with Scrub Typhus: A Case Report and Epidemiology of Scrub Typhus in the Maldives
Hisham Ahmed Imad 1,2,* , Aishath Azna Ali 3, Mariyam Nahuza 3, Rajan Gurung 3, Abdulla Ubaid 3,
Aishath Maeesha 4, Sariu Ali Didi 4, Rajib Kumar Dey 4, Abdullah Isneen Hilmy 4,5, Aishath Hareera 6,
Ibrahim Afzal 6, Wasin Matsee 7 , Wang Nguitragool 1,8, Emi. E. Nakayama 2 and Tatsuo Shioda 2
Scrub typhus is a neglected tropical disease predominantly occurring in Asia. The causative
agent is a bacterium transmitted by the larval stage of mites found in rural vegetation in endemic
regions. Cases of scrub typhus frequently present as acute undifferentiated febrile illness, and without
early diagnosis and treatment, the disease can develop fatal complications. We retrospectively
reviewed de-identified data from a 23-year-old woman who presented to an emergency department
with complaints of worsening abdominal pain. On presentation, she appeared jaundiced and
toxic-looking. Other positive findings on abdominal examination were a positive Murphey’s sign,
abdominal guarding and hepatosplenomegaly. Magnetic resonance cholangiopancreatography
demonstrated acalculous cholecystitis.
