{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:13:21Z","timestamp":1789398801616,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":62,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Scrub typhus is an acute infectious disease caused by\n                    <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                    , whose pathophysiology is characterized by systemic small\u2010vessel vasculitis. Its high misdiagnosis rate stems from its nonspecific clinical features. If not diagnosed and treated in time, patients may rapidly progress to multiorgan dysfunction syndrome (MODS) or even disseminated intravascular coagulation (DIC), posing a severe threat to life.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    The patient was a 68\u2010year\u2010old male with \u201crecurrent fever and dry cough for six days.\u201d He was admitted to the hospital with a diagnosis of scrub typhus. After admission, he developed severe acute respiratory distress syndrome (ARDS), MODS, septic shock, DIC with thrombocytopenia, hypofibrinogenemia, significant hyperfibrinolysis, and myocardial depression. The patient improved following treatment with doxycycline, moxifloxacin, renal replacement therapy, blood transfusion, antifibrinolysis, invasive mechanical ventilation, and other supportive therapies. The patient\u2019s coagulation profile in DIC caused by scrub typhus demonstrated significant hyperfibrinolysis, differing from that of garden\u2010variety sepsis, and no similar cases were identified in a search of medical literature\/databases.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The fibrinolytic system in DIC caused by scrub typhus is excessively active, and antifibrinolytic therapy may benefit such patients. Further research on the distinct coagulation abnormalities in scrub typhus\u2013associated DIC would be highly valuable compared to sepsis\u2010associated DIC.\n                  <\/jats:p>","DOI":"10.1155\/crdi\/1931423","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:36:08Z","timestamp":1741739768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scrub Typhus Combined With Septic Shock Disseminated Intravascular Coagulation and Significant Hyperfibrinolysis: A Case Report and Review of the Literature"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-874X","authenticated-orcid":false,"given":"Dewen","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7685-7535","authenticated-orcid":false,"given":"Xiaohong","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5882-2312","authenticated-orcid":false,"given":"Haihui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5371-2318","authenticated-orcid":false,"given":"Liying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9200-1075","authenticated-orcid":false,"given":"Ankang","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0108-6427","authenticated-orcid":false,"given":"Quping","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2782-971X","authenticated-orcid":false,"given":"You","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8215-2284","authenticated-orcid":false,"given":"Shunhang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1286-4579(00)01352-6"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/596576"},{"key":"e_1_2_10_3_2","article-title":"A Systematic Review of Mortality From Untreated Scrub Typhus (Orientia Tsutsugamushi)","volume":"9","author":"Taylor A. 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