Insight into the Role of Optical Coherence Tomography in Acute Coronary Syndrome following Scrub Typhus: A Case Report

Abstract

Scrub typhus, an illness stemming from the Orientia tsutsugamushi bacterium within the Rickettsiaceae family, is recognised for its febrile nature and frequently linked to vasculitis-induced complications. The challenges faced in the management of scrub typhus complicated by Acute Coronary Syndrome (ACS) and Multiple Organ Dysfunction Syndrome (MODS) is presented in this case report. Of particular significance, this report introduces a novel approach of employing Optical Coherence Tomography (OCT) to identify the underlying pathology, which guided us in making the treatment decision-a novel application of OCT in infectious disease management yet to be documented in the existing medical literature. In present case, OCT was used and the lesion was characterised to be vasculitic and not atherosclerotic, thereby changing the entire treatment course, benefiting the patient. This innovative utilisation of OCT throws light over vasculitic pathology of present case and emphasises the need for intracoronary imaging in the management of this rare complication of a fairly common tropical disease.

Keywords

• acute coronary syndrome
• interventional cardiology
• vasculitis