Case presentation A 10-year-old girl was admitted with a seven-day history of high-grade intermittent fever accompanied by chills and rigors. Shortly thereafter, she developed multiple painful erythematous nodules involving the trunk and extremities (Figure 1). Ten days ago, she had sustained trauma to her left lower leg from a rope tied to an animal, followed by the appearance of a fluid-filled lesion at the site of injury.
Figure 1 . Tender erythematous subcutaneous nodules over the proximal lower limb (A) and trunk (C) Laboratory findings Pancytopenia Elevated serum ferritin (971 ng/mL) and D-dimer (2,740 pg/mL) Inflammatory markers: Within normal limits Scrub typhus serology: Positive Initial treatment and disease course High-dose IV methylprednisolone was initiated, followed by oral prednisolone and cyclosporine from day 5 of admission Fever resolved within 48 hours Progressive…
