Key Clinical Message
Glucose 6 phosphate dehydrogenase (G6PD) deficiency is a well-known red
blood cell enzymopathy and a cause of intravascular hemolysis. The
patient may present with a chronic or acute episode of hemolysis. This
case report presents a child with underlying G6PD deficiency who
presented with an episode of extensive intravascular hemolysis, induced
by a scrub typhus infection. The essence of this report is a scrub
typhus infection without a typical eschar and a covert G6PD enzyme
activity found normal during the acute phase of hemolysis, later found
to be mild enzyme deficient. Later in the report is how, after
systematically ruling out other potential causes, the diagnosis of scrub
typhus was eventually confirmed using a reliable serology kit and a
false negative covert G6PD enzyme deficiency got uncovered in follow-up
reports.