Backgroud: Tsutsugamushi disease was really uncommon in the pediatric clinical.
However, it can be quite severe, those who suffer them Tsutsugamushi disease can progress to
multiple organ dysfunction syndrome (MODS) and hemophagocytic syndrome (HPS). Unfortunately,
there were few reports on pulmonary hemorrhage caused by tsutsugamushi disease, especially in
children. Because of the nonspecific clinical presentations, it was difficult to differentiate from other
diseases. The mortality would be up to 60% if inappropriate antibiotics were used.
Case Presentation: We report a three-year-old girl infected with tsutsugamushi, which manifested as
MODS, HPS and diffuse alveolar hemorrhage. After administation of chloromycetin, the patient’s temperature fell down
to normal 2 days later and mechanical ventilation was stopped after 1 week. The patient was discharged after three weeks
of treatment. Since the typical eschar of tsutsugamushi disease is mostly concealed, misdiagnosis and delay in treatment
often cause severe complications.
Conclusion: Chloromycetin may be an alternative antibiotic choice of treatment for severe pediatric tsutsugamushi
disease, though it has toxic effects on bone marrow hematopoietic function.