Bush Fever

A 23 year old man presents with a productive cough with mucoid sputum for 2 days, in a background of high-grade fever, nausea and vomiting for 6 days.

Furthermore, he experienced a mild generalized headache, myalgia and a widespread itchy rash for the last 10 days.

He returned from a military training course in India 3 days ago. He has not obtained any treatment so far, except acetaminophen for fever.

His medical history is otherwise unremarkable.

Select Relevant Investigations
Full Blood Count


WBC: 13,000/mm3 (4000-11,000)
N: 50% (50-70)
L: 45% (20-40)
Hb: 14.5g/dL (13.5-17.5)
Platelets: 190,000/mm3 (150,000-400,000)
Chest Radiograph


B/L non-homogenous infiltrates in lower zones of both lungs, R>L
Indirect FAT


The indirect Fluorescence Antibody Test (FAT) is reactive for Orientia tsutsugamushi
Blood Cultures


Culture results will be available in 3 days.

Select Relevant Management
Isolate Patient
Admit to Hospital