Scrub Typhus: Two Cases Presenting as Abdominal Pain

Scrub typhus, which is caused by Orientia tsutsugamushi, has various systemic manifestations, including GI symptoms. We describe one patient with scrub typhus who presented with symptoms that suggested acute appendicitis and another who presented with symptoms of acute cholecystitis. The first patient underwent appendectomy, which revealed no pathological findings in the appendix; subsequently, she was successfully treated with azithromycin and doxycycline. The other patient recovered after doxycycline treatment without cholecystectomy. Therefore, the clinical conditions related to acute surgical abdomen in patients with scrub typhus should be differentiated carefully to avoid unnecessary surgery. [Infect Med. 2009;26:158-160]