Clinical manifestations and complications of scrub typhus: A hospital-based study from North Andhra

Abstract

Aims and Objectives: To describe the diversity of clinical manifestations, laboratory findings, and outcome of scrub typhus in hospitalized patients of Tirumala Hospital, Vizianagaram, during 2014–2015. Materials and Methods: All cases of acute febrile illness diagnosed as scrub typhus were analyzed. Diagnosis was made by ELISA-based IgM serology. Observations and Results: A total of sixty patients were included in the study. All of them presented with fever; the other major symptoms were headache, cough, dyspnea, and myalgias. On examination, patients had hepatosplenomegaly, lymphadenopathy, and eschar. On investigation, elevated serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase with normal and elevated bilirubin levels were the most common findings. Other laboratory findings were thrombocytopenia and deranged renal function tests.Other complications were multiorgan dysfunction syndrome, acute respiratory distress syndrome, hypotension, and meningoencephalitis. Majority responded to doxycycline. Conclusion: Scrub typhus though prevalent is under-reported in our country. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.