Scrub Typhus Co-infection in an Adolescent Girl with Varicella.

Background: Co-infections with scrub typhus have been described quite frequently in adults but less frequently in children. Case characteristics: An adolescent girl with varicella infection who had persistent fever. Associated clinical features like pain abdomen, vomiting, and features of third space losses made us suspect a co-infection. IgM and IgG antibodies by ELISA in acute and convalescent serum were suggestive of scrub typhus. Outcome: She recovered following a course of oral doxycycline. Message: In unexplained prolonged fever or atypical clinical manifestations not explainable by the primary disease process, coinfection needs to be considered.