RESUMO
Tsutsugamushi disease (scrub typhus) is a rickettsian febrile disease which is seldom found in pregnancy. A 28-year-old woman was infected with scrub typhus at the 22th week of gestation which was diagnosed on the basis of clinical features. A serology for Tsutsugamushi was negative at that time. Therapy with tetracycline (doxycycline) or chloramphenicol is currently recommended for the treatment. However these drugs which are class D drugs according to the USA FDA, and Fetal Risk Summary, should not be used to treat pregnant women. Recently azithromycin, a new macrolide antibiotic, has been proven to be more effective than doxycycline. Moreover, there is no evidence that azithromycin causes harm to the developing fetus or to children. Here we describe a pregnant patient with Tsutsugamushi disease who was treated successfully with azithromycin without complications.