{"id":10434,"date":"2025-08-07T09:12:21","date_gmt":"2025-08-07T09:12:21","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/ima-journal\/?p=10434"},"modified":"2025-08-07T09:37:05","modified_gmt":"2025-08-07T09:37:05","slug":"all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/","title":{"rendered":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys"},"content":{"rendered":"<p class=\"caps\">[vc_section][vc_row][vc_column][vc_column_text]<\/p>\n<h2>CASE HISTORY:<\/h2>\n<p>A 23-year-old previously healthy male, with no known comorbidities presented with 10 days of high-grade fever, watery diarrhea, diffuse crampy abdominal pain, vomiting, chills and rigors. He had a history of outside food intake prior to symptom onset. Initially Patient was admitted in an outside hospital and was treated\u00a0 with intravenous cefoperazone-sulbactam and metronidazole from day 5 of fever yet showed no improvement.<\/p>\n<p>On evaluation, platelet count dropped from 76,000 to 39,000 within 24 hours, on day 5. Due to persistent symptoms ,he was brought here for further management.<\/p>\n<h2>ON EXAMINATION:<\/h2>\n<p>The patient was conscious, oriented , febrile, Dehydrated and icteric. The patient was dyspneic and tachypneic. Bp- 150\/82 mmHg, PR-136\/min, SPO2 \u2013 96 in room air, RR- 30\/min. CVS- S1 S2 present, No murmurs. RS- BAE present. NVBS. No added sounds. P\/A-\u00a0 Diffuse tenderness, guarding, rigidity more towards the epigastric , right and left hypochondrial and right iliac fossa.<\/p>\n<p>At admission to our facility on day 11 of fever, labs revealed: Hb 11.5 g\/dL, WBC 3760\/\u00b5L with 82% neutrophils, platelets 81,000\/\u00b5L, SGOT 569 U\/L, SGPT 168 U\/L, GGT 200 U\/L, urea 54.8 mg\/dL, creatinine 1.96 mg\/dL, sodium 131 mEq\/L, potassium 2.7 mEq\/L, phosphorus 1.8 mg\/dL. CRP was elevated at 133.4 mg\/L, NT-proBNP 11284 pg\/mL, procalcitonin 17.35 ng\/mL. Serum lipase was 284.6 U\/L and amylase 707.3 U\/L. Troponin I was significantly elevated at 112.17 ng\/L, and CPK was 1341.6 U\/L. Urine microscopy revealed 8\u201310 isomorphic RBCs per high-power field.<\/p>\n<h2>COURSE IN THE HOSPITAL:<\/h2>\n<p>CT abdomen with contrast showed ileocolitis involving the terminal ileum, appendix, and cecum with mesenteric lymphadenopathy, hepatosplenomegaly, ascites, and enlarged kidneys with perinephric fat stranding. CT chest revealed bilateral pleural effusions, basal lung consolidations, and enlarged pulmonary arteries suggestive of systemic inflammation.<\/p>\n<p>ECHO done showed Mild PAH with PASP- 45, otherwise no significant abnormality.<\/p>\n<h3>DIFFERENTIAL DIAGNOSIS:<\/h3>\n<p>The above findings confirm the presence of multi-system involvement<\/p>\n<ul class=\"list\">\n<li>Enteric fever (Typhoid \/paratyphoid )- But it doesn\u2019t explain very high CRP , thrombocytopenia, myocarditis and pancreatitis<\/li>\n<li>Scrub Typhus \u2013 possible due to multi organ dysfunction<\/li>\n<li>Leptospirosis<\/li>\n<li>Severe Dengue with systemic involvement- but doesn\u2019t explain diarrhea, high CRP or pancreatitis.<\/li>\n<li>Acute viral hepatitis- Less likely to cause this degree of systemic inflammation<\/li>\n<li>Tuberculosis- (Abdominal + disseminated) \u2013 but doesn\u2019t explain acute onset and high-grade fevers<\/li>\n<\/ul>\n<h2>DIAGNOSIS:<\/h2>\n<p>Serologic testing revealed Typhidot IgM and Scrub typhus IgM positivity. Blood cultures were sterile, likely due to prior antibiotics. A diagnosis of co-infection with typhoid fever and scrub typhus was established.<\/p>\n<h2>MANAGEMENT:<\/h2>\n<p>The patient was admitted\u00a0 and started on intravenous ceftriaxone- 2 grams IV BD\u00a0 and doxycycline 100mg BD over 7 days. Clinical improvement was noted within 48\u201372 hours. Supportive treatment included fluid and electrolyte correction, potassium repletion, and monitoring for cardiac and renal function. The patient was supportively managed by the Intensive Care Unit team , surgeon, cardiologist and nephrologist in a multidisciplinary approach.<\/p>\n<h2>OUTCOME:<\/h2>\n<p>Over the course of a week, the patient&#8217;s symptoms resolved, and laboratory parameters gradually normalized. Repeat ECHO showed resolution of PAH. He was discharged with oral antibiotics , diuretics, fluid restriction as outpatient follow-up and complete recovery.<\/p>\n<h2>DISCUSSION:<\/h2>\n<p>This case illustrates the diagnostic complexity of co-infections in endemic regions. Both typhoid and scrub typhus are common causes of febrile illness, yet simultaneous infection is rare and often underrecognized. The patient\u2019s multi-organ involvement, resistance to monotherapy, and response to combined treatment underscored the importance of broad diagnostic evaluation in persistent tropical fevers. Awareness and timely intervention are key to preventing morbidity in such overlapping infections.<\/p>\n<p>Scrub\u00a0 typhus is a serious public health\u00a0 problem in the &#8220;tsutsugamushi triangle&#8221; region,\u00a0 which comprises the Asia-Pacific nations and the Indian subcontinent [1].The disease is\u00a0 prevalent in India&#8217;s Sub-Himalayan region, which extends from Jammu and Kashmir to Nagaland. It is also prevalent in West Bengal, Tamil Nadu, and Kerala. Scrub typhus is a tropical infectious disease caused by Orientia tsutsugamushi, a\u00a0 gram-negative,\u00a0\u00a0 intracellular, obligatory pathogen whose polysaccharides have an antigenic association\u00a0 with proteus\u00a0 OX-K\u00a0 and are therefore utilised in serologic testing to diagnose scrub typhus. Most common presentations include fever, exanthematous rash, myalgia, headache, gastrointestinal problems, dyspnea, jaundice, and\u00a0 eschar formation. In\u00a0\u00a0\u00a0 extreme cases, multiorgan dysfunction\u00a0 syndrome (MODS), meningitis, encephalitis, acute respiratory distress\u00a0 syndrome, acute lung injury\u00a0 (ALI),\u00a0 pre-renal\u00a0 AKI,\u00a0 and\u00a0 myocarditis might\u00a0 occur. The\u00a0 severity\u00a0 of\u00a0 renal\u00a0 involvement\u00a0 caused\u00a0 by scrub\u00a0\u00a0 \u00a0\u00a0typhus\u00a0 infection\u00a0 can\u00a0 range from asymptomatic urine abnormalities to renal failure requiring\u00a0 dialysis. Acute\u00a0 arrest\u00a0 of hemopoiesis (AAH) which\u00a0 usually results\u00a0 in\u00a0\u00a0 pancytopenia, might occur with scrub infection and patients will have\u00a0 a\u00a0 considerable\u00a0 improvement\u00a0 in their\u00a0 blood routine\u00a0 for about a week after receiving supportive\u00a0 care.<\/p>\n<h2>CONCLUSION:<\/h2>\n<p>Co-infection with Salmonella typhi and scrub typhus should be considered in patients presenting with systemic symptoms, gastrointestinal complaints, and organ dysfunction in endemic areas. Empirical treatment targeting both pathogens may be warranted when diagnostic ambiguity exists.<\/p>\n<h2>REFERENCE:<\/h2>\n<p>1) Lallawmkima I, Vanlalruati R, Chongthu JL, Renthlei L. Scrub Typhus with Multi-Organ Dysfunction Syndrome and Immune Thrombocytopenia: A Case Report. Infect Dis Clin Microbiol. 2022 Jun 13;4(2):133-136. doi: 10.36519\/idcm.2022.95. PMID: 38633345; PMCID: PMC10986586.<\/p>\n<p>2)A Rare Presentation of Scrub Typhus: Multi-Organ Dysfunction [Acute Kidney Injury, Hepatitis] and Acute Respiratory Distress Syndrome<br \/>\nPublished: 2023-01-05 | DOI: 10.9734\/ajrid\/2023\/v12i1232 | Page: 1-7 | Issue: 2023 &#8211; Volume 12 [Issue 1]<\/p>\n<p>3)Typhoid and Scrub Typhus Coinfection in a Returned Traveler<br \/>\nSAGE Publications Inc | Global Pediatric Health | August 20174(2):2333794X1772694<br \/>\nDOI:10.1177\/2333794X17726941 | LicenseCC BY-NC 4.0<\/p>\n<p>4)Bhattarai BR, Bhujel R, Pokhrel S, Mishra A, Priyadarshinee A. Co-infection of dengue, scrub typhus, and typhoid during dengue outbreak in Nepal, 2022: A case report. Clin Case Rep. 2023 Mar 14;11(3):e7080. doi: 10.1002\/ccr3.7080. PMID: 36937629; PMCID: PMC10014518.<\/p>\n<div class=\"row\" style=\"padding-top: 30px;\">\n<div class=\"col-md-2 col-sm-4 col-xs-4 paddingbottom\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-7642\" src=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/11\/Dr-Jayaraman2021-01-04-06_42_55am.jpg\" alt=\"\" width=\"600\" height=\"703\" srcset=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/11\/Dr-Jayaraman2021-01-04-06_42_55am.jpg 600w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2023\/11\/Dr-Jayaraman2021-01-04-06_42_55am-256x300.jpg 256w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/div>\n<div class=\"col-md-10 col-sm-8 col-xs-8 paddingbottom\">\n<p style=\"font-size: 15px;\" align=\"left\"><b>Dr. K Jayaraman<br \/>\nSenior Consultant Internal Medicine Specialist and Diabetologist,<br \/>\n<a href=\"https:\/\/www.kauveryhospital.com\/\">Kauvery Hospital Chennai<\/a><\/b><\/p>\n<\/div>\n<\/div>\n<div class=\"row\" style=\"padding-top: 30px;\">\n<div class=\"col-md-2 col-sm-4 col-xs-4 paddingbottom\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-10120\" src=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/04\/roseline.jpg\" alt=\"\" width=\"661\" height=\"1047\" srcset=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/04\/roseline.jpg 661w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/04\/roseline-189x300.jpg 189w, https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/04\/roseline-646x1024.jpg 646w\" sizes=\"auto, (max-width: 661px) 100vw, 661px\" \/><\/div>\n<div class=\"col-md-10 col-sm-8 col-xs-8 paddingbottom\">\n<p style=\"font-size: 15px;\" align=\"left\"><b>Dr N Roseline Sweety Jebapriya<br \/>\nDNB General Medicine First Year Resident,<br \/>\n<a href=\"https:\/\/www.kauveryhospital.com\/\">Kauvery Hospital Chennai<\/a><\/b><\/p>\n<\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][\/vc_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_section][vc_row][vc_column][vc_column_text] CASE HISTORY: A 23-year-old previously healthy male, with no known comorbidities presented with 10 days of high-grade fever, watery diarrhea, diffuse crampy abdominal pain, vomiting, chills and rigors. He<\/p>\n","protected":false},"author":2,"featured_media":10435,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[91],"tags":[],"class_list":["post-10434","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ima-journal-august-2025"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys\" \/>\n<meta property=\"og:description\" content=\"[vc_section][vc_row][vc_column][vc_column_text] CASE HISTORY: A 23-year-old previously healthy male, with no known comorbidities presented with 10 days of high-grade fever, watery diarrhea, diffuse crampy abdominal pain, vomiting, chills and rigors. He\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/\" \/>\n<meta property=\"og:site_name\" content=\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\" \/>\n<meta property=\"article:published_time\" content=\"2025-08-07T09:12:21+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-08-07T09:37:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1308\" \/>\n\t<meta property=\"og:image:height\" content=\"545\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"kh-ima-admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"kh-ima-admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/\",\"name\":\"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys\",\"isPartOf\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg\",\"datePublished\":\"2025-08-07T09:12:21+00:00\",\"dateModified\":\"2025-08-07T09:37:05+00:00\",\"author\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb\"},\"breadcrumb\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg\",\"contentUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg\",\"width\":1308,\"height\":545,\"caption\":\"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#website\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/\",\"name\":\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\",\"description\":\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb\",\"name\":\"kh-ima-admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g\",\"caption\":\"kh-ima-admin\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/","og_locale":"en_US","og_type":"article","og_title":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys","og_description":"[vc_section][vc_row][vc_column][vc_column_text] CASE HISTORY: A 23-year-old previously healthy male, with no known comorbidities presented with 10 days of high-grade fever, watery diarrhea, diffuse crampy abdominal pain, vomiting, chills and rigors. He","og_url":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/","og_site_name":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","article_published_time":"2025-08-07T09:12:21+00:00","article_modified_time":"2025-08-07T09:37:05+00:00","og_image":[{"width":1308,"height":545,"url":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg","type":"image\/jpeg"}],"author":"kh-ima-admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"kh-ima-admin","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/","name":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys","isPartOf":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage"},"image":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage"},"thumbnailUrl":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg","datePublished":"2025-08-07T09:12:21+00:00","dateModified":"2025-08-07T09:37:05+00:00","author":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb"},"breadcrumb":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#primaryimage","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg","contentUrl":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2025\/08\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys.jpg","width":1308,"height":545,"caption":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys"},{"@type":"BreadcrumbList","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/all-in-one-involvement-a-diagnostic-maze-of-a-febrile-young-man-involving-the-gut-lungs-heart-pancreas-and-kidneys\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.kauveryhospital.com\/ima-journal\/"},{"@type":"ListItem","position":2,"name":"All-in-One Involvement: A Diagnostic Maze of a Febrile Young Man \u2013 Involving the Gut, Lungs, Heart, Pancreas and Kidneys"}]},{"@type":"WebSite","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#website","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/","name":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","description":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.kauveryhospital.com\/ima-journal\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb","name":"kh-ima-admin","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g","caption":"kh-ima-admin"}}]}},"_links":{"self":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/10434","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/comments?post=10434"}],"version-history":[{"count":3,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/10434\/revisions"}],"predecessor-version":[{"id":10438,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/10434\/revisions\/10438"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/media\/10435"}],"wp:attachment":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/media?parent=10434"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/categories?post=10434"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/tags?post=10434"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}