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Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India.
Natl Med J India 2017 Mar-Apr; 30(2):69-72NM

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.

Authors+Show Affiliations

Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India.Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India.Department of Dermatology, Government Medical College, Kota, Rajasthan, India.Department of Conservative Dentistry and Endodontics, Jodhpur Dental College and General Hospital, Jodhpur, Rajasthan, India.Department of Internal Medicine, Government Medical College, Kota, Rajasthan, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28816212

Citation

Takhar, Rajendra Prasad, et al. "Scrub Typhus: a Prospective, Observational Study During an Outbreak in Rajasthan, India." The National Medical Journal of India, vol. 30, no. 2, 2017, pp. 69-72.
Takhar RP, Bunkar ML, Arya S, et al. Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India. Natl Med J India. 2017;30(2):69-72.
Takhar, R. P., Bunkar, M. L., Arya, S., Mirdha, N., & Mohd, A. (2017). Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India. The National Medical Journal of India, 30(2), pp. 69-72.
Takhar RP, et al. Scrub Typhus: a Prospective, Observational Study During an Outbreak in Rajasthan, India. Natl Med J India. 2017;30(2):69-72. PubMed PMID: 28816212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India. AU - Takhar,Rajendra Prasad, AU - Bunkar,Moti Lal, AU - Arya,Savita, AU - Mirdha,Nitin, AU - Mohd,Arif, PY - 2017/8/18/entrez PY - 2017/8/18/pubmed PY - 2019/1/23/medline SP - 69 EP - 72 JF - The National medical journal of India JO - Natl Med J India VL - 30 IS - 2 N2 - 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. SN - 0970-258X UR - https://www.unboundmedicine.com/medline/citation/28816212/Scrub_typhus:_A_prospective_observational_study_during_an_outbreak_in_Rajasthan_India_ L2 - http://www.nmji.in/article.asp?issn=0970-258X;year=2017;volume=30;issue=2;spage=69;epage=72;aulast=Takhar DB - PRIME DP - Unbound Medicine ER -