Melioidosis and scrub typhus co-infection in a patient presenting with acute undifferentiated febrile illness

Muhammad Yazli Yuhana (Infectious Diseases Unit, Department of Internal Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia)
Ampai Tanganuchitcharnchai (Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)
Pimpan Sujariyakul (Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)
Piengchan Sonthayanon (Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)
Kesinee Chotivanich (Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)
Daniel H. Paris (Swiss Tropical and Public Health Institute, Basel, Switzerland)
Sasithon Pukrittayakamee (Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)
Stuart D. Blacksell (Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, Oxford, United Kingdom)
Borimas Hanboonkunupakarn (Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)

JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
JKKI, Vol 10, No 1, (2019)

Melioidosis and scrub typhus are endemic diseases in Malaysia. However, unlike melioidosis, scrub typhus is more difficult to be diagnosed and in Malaysia its true disease burden is unknown. We report a case of severe melioidosis and scrub typhus co-infection in a patient living in a small village in Peninsular Malaysia whom presented with fever and headache. This case highlights the importance of considering scrub typhus as a diagnostic possibility in cases of acute undifferentiated febrile illness in rural areas such as that of in Peninsular Malaysia.