Epistaxis, Maculopapular Rash and Fever in a German Boy After a Stay in Thailand Caused by Orientia Tsutsugamushi

Introduction

Tsutsugamushi fever, also known as scrub typhus, is caused by the obligate intracellular bacterium Orientia tsutsugamushi. This pathogen can be transmitted to humans by bites of chigger mites within the so-called “Tsutsugamushi Triangle” delimited by India, Japan, and Australia. Although scrub typhus often affects children in endemic regions, it is only rarely diagnosed in febrile children returning from such areas. Here, we present the case of a German boy who developed fever, generalized rash, and epistaxis after returning from a holiday stay in Thailand.