Rajendra Prasad Takhar1, Moti Lal Bunkar1, Savita Arya2, Nitin Mirdha3, Arif Mohd4. 1. Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India. 2. Department of Dermatology, Government Medical College, Kota, Rajasthan, India. 3. Department of Conservative Dentistry and Endodontics, Jodhpur Dental College and General Hospital, Jodhpur, Rajasthan, India. 4. Department of Internal Medicine, Government Medical College, Kota, Rajasthan, India.
Abstract
BACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital. METHODS: In this descriptive study, we included all patients with an acute febrile illness diagnosed as scrub typhus by positive IgM antibodies against O. tsutsugamushi, over a period of 4 months (July to October 2014). All relevant data were recorded and analysed. RESULTS: A total of 66 (24 males/42 females) patients were enrolled. Fever was the most common presenting symptom (100%), and in 67% its duration was for 7-14 days. Other symptoms were breathlessness (66.7%), haemoptysis (63.6%), oliguria (51.5%) and altered mental status (39.4%). The pathognomonic features such as eschar (12%) and lymphadenopathy (18%) were not so common. The commonest radiological observation was consistent with acute respiratory distress syndrome. Complications noted were respiratory (69.7%), renal (51.5%) and hepatic dysfunction (48.5%). The overall mortality rate was 21.2%. CONCLUSIONS: Scrub typhus has emerged as an important cause of febrile illness in the Hadoti region and can present with varying clinical manifestations with or without eschar. A high index of suspicion, early diagnosis and prompt intervention may help in reducing the mortality.
BACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital. METHODS: In this descriptive study, we included all patients with an acute febrile illness diagnosed as scrub typhus by positive IgM antibodies against O. tsutsugamushi, over a period of 4 months (July to October 2014). All relevant data were recorded and analysed. RESULTS: A total of 66 (24 males/42 females) patients were enrolled. Fever was the most common presenting symptom (100%), and in 67% its duration was for 7-14 days. Other symptoms were breathlessness (66.7%), haemoptysis (63.6%), oliguria (51.5%) and altered mental status (39.4%). The pathognomonic features such as eschar (12%) and lymphadenopathy (18%) were not so common. The commonest radiological observation was consistent with acute respiratory distress syndrome. Complications noted were respiratory (69.7%), renal (51.5%) and hepatic dysfunction (48.5%). The overall mortality rate was 21.2%. CONCLUSIONS: Scrub typhus has emerged as an important cause of febrile illness in the Hadoti region and can present with varying clinical manifestations with or without eschar. A high index of suspicion, early diagnosis and prompt intervention may help in reducing the mortality.
Authors: Alison Luce-Fedrow; Marcie L Lehman; Daryl J Kelly; Kristin Mullins; Alice N Maina; Richard L Stewart; Hong Ge; Heidi St John; Ju Jiang; Allen L Richards Journal: Trop Med Infect Dis Date: 2018-01-17
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Authors: Sudhir K Verma; Kamlesh K Gupta; Rajesh K Arya; Vivek Kumar; D Himanshu Reddy; Shyam C Chaudhary; Satyendra K Sonkar; Satish Kumar; Neeraj Verma; Deepak Sharma Journal: J Family Med Prim Care Date: 2021-04-08