Acute Pancreatitis Associated with Scrub Typhus: Report of two cases with a brief review of literature.

Acute pancreatitis is an exceptionally rare complication of scrub typhus. We report 2 cases of scrub typhus-associated acute pancreatitis from a tertiary care centre in Kolkata, India. The first case was a 27-year-old male patient, who presented in 2023, with severe epigastric pain a few days after the onset of fever. Laboratory investigations confirmed acute pancreatitis associated with scrub typhus. He had no additional organ involvement and recovered fully with intravenous doxycycline. The second case, reported in 2024, was a 42-year-old female patient who presented with fever, abdominal pain, vomiting and systemic complications, including acute kidney injury, hepatic dysfunction and pulmonary involvement. Despite the absence of eschar, investigations confirmed the diagnosis of scrub typhus. She achieved full recovery with doxycycline, haemodialysis and other supportive measures. Both cases emphasise the importance of considering scrub typhus in the differential diagnosis of acute pancreatitis in endemic regions, particularly when accompanied by febrile illness.