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Eschar in scrub typhus: a valuable clue to the diagnosis.
J Postgrad Med. 2013 Jul-Sep; 59(3):177-8.JP

Abstract

BACKGROUND

Scrub typhus is an acute febrile illness widely prevalent in the 'tsutsugamushi triangle' region of the world. Clinical features include fever, myalgia, headache, rash, and a pathognomonic eschar. An eschar is formed by the bite of chigger mite that inoculates the causative agent of Scrub typhus Orientia tsutsugamushi. The aim of this study is to determine the most common sites of eschars over the bodies of patients with Scrub typhus.

MATERIALS AND METHODS

In a retrospective analysis, we examined a total of 418 patients who presented to Christian Medical College, Vellore between 2009 and 2012 with an acute febrile illness and an eschar on clinical examination and confirmed to have scrub typhus with a positive Scrub typhus IgM ELISA test. We studied the distribution of eschars over the bodies of 418 patients with Scrub typhus.

RESULTS

There was a significant difference in the distribution of eschars between males and females with a preponderance of the chest and abdomen (42.3%) among females and the axilla, groin and genitalia (55.8%) in males. Some unusual sites of an eschar were the cheek, ear lobe and dorsum of the feet.

CONCLUSION

The eschar is the most useful diagnostic clue in patients with acute febrile illness in areas endemic for Scrub typhus and therefore should be thoroughly examined for its presence especially over the covered areas such as the groin, genitalia, infra-mammary area and axilla.

Authors+Show Affiliations

Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24029193

Citation

Kundavaram, A P., et al. "Eschar in Scrub Typhus: a Valuable Clue to the Diagnosis." Journal of Postgraduate Medicine, vol. 59, no. 3, 2013, pp. 177-8.
Kundavaram AP, Jonathan AJ, Nathaniel SD, et al. Eschar in scrub typhus: a valuable clue to the diagnosis. J Postgrad Med. 2013;59(3):177-8.
Kundavaram, A. P., Jonathan, A. J., Nathaniel, S. D., & Varghese, G. M. (2013). Eschar in scrub typhus: a valuable clue to the diagnosis. Journal of Postgraduate Medicine, 59(3), 177-8. https://doi.org/10.4103/0022-3859.118033
Kundavaram AP, et al. Eschar in Scrub Typhus: a Valuable Clue to the Diagnosis. J Postgrad Med. 2013 Jul-Sep;59(3):177-8. PubMed PMID: 24029193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eschar in scrub typhus: a valuable clue to the diagnosis. AU - Kundavaram,A P, AU - Jonathan,A J, AU - Nathaniel,S D, AU - Varghese,G M, PY - 2013/9/14/entrez PY - 2013/9/14/pubmed PY - 2014/6/5/medline SP - 177 EP - 8 JF - Journal of postgraduate medicine JO - J Postgrad Med VL - 59 IS - 3 N2 - BACKGROUND: Scrub typhus is an acute febrile illness widely prevalent in the 'tsutsugamushi triangle' region of the world. Clinical features include fever, myalgia, headache, rash, and a pathognomonic eschar. An eschar is formed by the bite of chigger mite that inoculates the causative agent of Scrub typhus Orientia tsutsugamushi. The aim of this study is to determine the most common sites of eschars over the bodies of patients with Scrub typhus. MATERIALS AND METHODS: In a retrospective analysis, we examined a total of 418 patients who presented to Christian Medical College, Vellore between 2009 and 2012 with an acute febrile illness and an eschar on clinical examination and confirmed to have scrub typhus with a positive Scrub typhus IgM ELISA test. We studied the distribution of eschars over the bodies of 418 patients with Scrub typhus. RESULTS: There was a significant difference in the distribution of eschars between males and females with a preponderance of the chest and abdomen (42.3%) among females and the axilla, groin and genitalia (55.8%) in males. Some unusual sites of an eschar were the cheek, ear lobe and dorsum of the feet. CONCLUSION: The eschar is the most useful diagnostic clue in patients with acute febrile illness in areas endemic for Scrub typhus and therefore should be thoroughly examined for its presence especially over the covered areas such as the groin, genitalia, infra-mammary area and axilla. SN - 0972-2823 UR - https://www.unboundmedicine.com/medline/citation/24029193/Eschar_in_scrub_typhus:_a_valuable_clue_to_the_diagnosis_ L2 - http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2013;volume=59;issue=3;spage=177;epage=178;aulast=Kundavaram DB - PRIME DP - Unbound Medicine ER -