{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:20Z","timestamp":1782489080088,"version":"3.54.5"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,20]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Congenital scrub typhus is a rare form of\n                    <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                    infection in neonates. Typical neonatal manifestations include fever, thrombocytopenia and hepatosplenomegaly; however, presentation in the form of non-immune hydrops fetalis (NIHF) is uncommon and has not been reported previously in literature. We report a case of vertically transmitted scrub typhus in a preterm neonate who presented with hydrops fetalis at birth. The diagnosis was established using molecular testing, and timely initiation of appropriate antimicrobial therapy resulted in complete recovery. This case and the accompanying literature review expand the clinical spectrum of congenital scrub typhus and highlight the importance of considering it as a treatable infectious cause of NIHF in endemic regions.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2026-272103","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:25:14Z","timestamp":1776270314000},"page":"e272103","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Congenital scrub typhus presenting as non-immune hydrops fetalis"],"prefix":"10.1136","volume":"19","author":[{"given":"Sivaranjani","family":"Tamilarasan","sequence":"first","affiliation":[{"name":"Neonatology, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V P","family":"Sathyamoorthy","sequence":"additional","affiliation":[{"name":"Neonatology, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8052-1719","authenticated-orcid":false,"given":"Ambalakkuthan","family":"Murugesan","sequence":"additional","affiliation":[{"name":"Neonatology, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026062608153820000_19.4.e272103.1","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1542\/peds.89.5.965","article-title":"Neonatal scrub typhus: a case report","volume":"89","author":"Wang","year":"1992","journal-title":"Pediatrics"},{"key":"2026062608153820000_19.4.e272103.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.1997.tb00809.x"},{"key":"2026062608153820000_19.4.e272103.3","doi-asserted-by":"crossref","first-page":"343","DOI":"10.4103\/0255-0857.118874","article-title":"First case series of emerging Rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing","volume":"31","author":"Aarthi","year":"2013","journal-title":"Indian J Med Microbiol"},{"key":"2026062608153820000_19.4.e272103.4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s12664-017-0761-5","article-title":"Scrub typhus causing neonatal hepatitis with acute liver failure - A case series","volume":"36","author":"Vajpayee","year":"2017","journal-title":"Indian J Gastroenterol"},{"key":"2026062608153820000_19.4.e272103.5","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00431-018-3143-9","article-title":"Clinical profile and outcome of children with scrub typhus from Chennai, South India","volume":"177","author":"Ganesh","year":"2018","journal-title":"Eur J Pediatr"},{"key":"2026062608153820000_19.4.e272103.6","doi-asserted-by":"crossref","unstructured":"Reddy J , Rajan N , Dinakaran S , et al . Neonatal Scrub Typhus \u2013 A Sepsis Mimic. Indian Pediatrics Case Reports 2021;173\u20135.","DOI":"10.4103\/ipcares.ipcares_138_21"},{"key":"2026062608153820000_19.4.e272103.7","doi-asserted-by":"crossref","first-page":"5463","DOI":"10.2147\/IDR.S378430","article-title":"A Neonate with Bacterial Meningitis Due to Vertically Transmitted Scrub Typhus","volume":"15","author":"Gao","year":"2022","journal-title":"Infect Drug Resist"},{"key":"2026062608153820000_19.4.e272103.8","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1177\/09732179221100609","article-title":"Neonatal Scrub Typhus\u2014A Case Report","volume":"36","author":"Mehta","year":"2022","journal-title":"Journal of Neonatology"},{"key":"2026062608153820000_19.4.e272103.9","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2022-253172","article-title":"Scrub typhus due to vertical transmission in a neonate: rare presentation of a common tropical infection","volume":"16","author":"Deglurkar","year":"2023","journal-title":"BMJ Case Rep"},{"key":"2026062608153820000_19.4.e272103.10","first-page":"121","article-title":"Vertical transmission of scrub typhus in newborns: a case report","volume":"9","author":"Patel","year":"2023","journal-title":"Int J Pediatr Res"},{"key":"2026062608153820000_19.4.e272103.11","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2023.1251746","article-title":"Congenital scrub typhus: a case report and literature review","volume":"11","author":"Liang","year":"2023","journal-title":"Front Pediatr"},{"key":"2026062608153820000_19.4.e272103.12","doi-asserted-by":"crossref","DOI":"10.1080\/22221751.2025.2542242","article-title":"Vertical transmission of scrub typhus: a case report of congenital infection","volume":"14","author":"Luo","year":"2025","journal-title":"Emerg Microbes Infect"},{"key":"2026062608153820000_19.4.e272103.13","doi-asserted-by":"crossref","DOI":"10.3390\/jcm14113671","article-title":"Hydrops Fetalis Caused by Congenital Syphilis: Case Series and a Comprehensive Review","volume":"14","author":"Yanase","year":"2025","journal-title":"J Clin Med"},{"key":"2026062608153820000_19.4.e272103.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004517","article-title":"Zika Virus Infection and Stillbirths: A Case of Hydrops Fetalis, Hydranencephaly and Fetal Demise","volume":"10","author":"Sarno","year":"2016","journal-title":"PLoS Negl Trop Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:21:37Z","timestamp":1782487297000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bcr-2026-272103"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272103","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}