Maternal Scrub Typhus in an Urban Setting with Successful Management and Healthy Neonatal Outcome: A Case Report

Scrub typhus, caused by Orientia tsutsugamushi, is a vector-borne zoonotic disease traditionally associated with rural and forested environments.Nevertheless, this case report describes the occurrence of scrub typhus in an urban setting during pregnancy.A 35-year-old woman at 25 weeks and 6 days of gestation presented with high fever, severe myalgia, and elevated liver enzyme levels without a clear infectious source.Laboratory data disclosed mild bicytopenia and increased levels of inflammatory markers.Despite no rural exposure, the patient reported frequent outdoor activity in urban parks.Scrub typhus was suspected and confirmed using a rapid diagnostic test.Treatment with azithromycin (500 mg daily) resulted in rapid defervescence, normalization of liver enzyme levels, and complete recovery.An eschar was later identified on the left hip.The pregnancy progressed uneventfully, and she delivered a healthy full-term infant at 39 weeks and 2 days.This case illustrates that scrub typhus can occur in urban environments and must be considered in the differential diagnosis of fever of unknown origin during pregnancy.Early recognition and timely azithromycin treatment are essential to prevent maternal and fetal complications.Continuous clinician awareness and public health surveillance are crucial as urban transmission becomes more common in endemic regions.