Wilawan ThipmontreeKittipong SuwattanabunpotYupin SupputtamonkolMaharaj Nakhon Ratchasima HospitalMahidol University2018-12-112019-03-142018-12-112019-03-142016-12-01American Journal of Tropical Medicine and Hygiene. Vol.95, No.6 (2016), 1284-1286000296372-s2.0-85005973802https://repository.li.mahidol.ac.th/handle/20.500.14594/40788Copyright © 2016 by The American Society of Tropical Medicine and Hygiene. Spontaneous rupture of the spleen is rarely described as a complication of scrub typhus infection. We report a previously healthy 74-year-old Thai female farmer who presented in Nakhon Ratchasima, Thailand, with a history of fever and malaise for 5 days, followed by abdominal pain for 1 day. An exploratory laparotomy was performed due to peritonitis. Operative findings revealed a ruptured spleen and hemoperitoneum. A splenectomy was performed afterward. Scrub typhus was confirmed by a 4-fold increase of IgM titer using an indirect immunofluorescence antibody assay and a positive result from the polymerase chain reaction targeting the 47-and 56-kDa genes in Orientia tsutsugamushi. She responded well to intravenous chloramphenicol and defervesced within 24 hours without any complication.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.4269/ajtmh.16-0089