Study of Clinical and Demographic Profile of Scrub Typhus Patients Admitted to a Tertiary Care Hospital in Central India

A. V. Dahiphle, Amit Achliya, Neel Chhajed, Vikram Rode, Kasturi Bhise

Abstract


Objectives: To study epidemiological characteristics, clinical features, laboratory findings, and clinical outcomes in cases of scrub typhus. Additionally, the study aims to identify the predictors of disease severity.

Methods: This cross-sectional study was conducted in the Department of General Medicine at Dr PDM Medical College in Amaravati, India. The study duration was 6 months, from July 2023 to December 2023. All clinically confirmed patients with scrub typhus were evaluated through history, clinical examination, and appropriate laboratory investigations. The clinical and laboratory profiles, hospital course, and outcomes were analyzed. Organ dysfunction upon admission was assessed using the sequential organ failure assessment (SOFA) score.

Results: A total of 200 cases were included in the study. The majority of the cases were in the age range of 31-40 years, and most of them were males. The highest number of scrub typhus cases occurred in September. The most common presenting symptoms were fever (81%), followed by nausea (37.5%), generalized weakness (34%), abdominal pain, eschar (21.5%), breathlessness, and cough (21% each), headache (19%), vomiting (15%), and altered sensorium (4.5%). The majority of patients (72.5%) did not experience any complications, while 55 patients (27.5%) developed multi-organ dysfunction syndrome (MODS) as a complication. The mortality rate was 1%.

Conclusion: Scrub typhus is a significant cause of acute febrile illness in the Vidarbha region of Maharashtra. It can present with various clinical manifestations, with or without an eschar. Early diagnosis and appropriate treatment of these cases can lead to minimal complications.


Keywords


Clinical Profile; Eschar; Multi-organ Dysfunction Syndrome; Scrub Typhus

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References


  1. Sadanandane C, Jambulingam P, Paily KP, et al. Occurrence of orientia tsutsugamushi, the etiological agent of scrub typhus in animal hosts and mite vectors in areas reporting human cases of acute encephalitis syndrome in the Gorakhpur Region of Uttar Pradesh, India. Vector Borne Zoonotic Dis. 2018;18(10):539-47. doi:10.1089/vbz.2017.2246
  2. Ogawa M, Takada N, Noda S, Takahashi M, Matsutani M, Kageyama D, et al. Genetic variation of leptotrombidium (acari: trombiculidae) mites carrying orientia tsutsugamushi, the bacterial pathogen causing scrub typhus. J Parasitol. 2023;109(4):340-348. doi:10.1645/22-97
  3. Griffith M, Peter JV, Karthik G, Ramakrishna K, Prakash JA, Kalki RC, et al. Profile of organ dysfunction and predictors of mortality in severe scrub typhus infection requiring intensive care admission. Indian J Crit Care Med. 2014;18(8):497-502. doi:10.4103/0972-5229.138145
  4. Luce-Fedrow A, Lehman ML, Kelly DJ, Mullins K, Maina AN, Stewart RL, et al. A Review of scrub typhus (orientia tsutsugamushi and related organisms): then, now, and tomorrow. Trop Med Infect Dis. 2018;3(1):8. doi:10.3390/tropicalmed3010008
  5. Kore VB, Mahajan SM. Recent threat of scrub typhus in India: a narrative review. Cureus. 2022;14(10):e30092. Published 2022 Oct 9. doi:10.7759/cureus.30092
  6. Chaudhry R, Thakur CK, Gupta N, Sagar T, Bahadur T, et al. Mortality due to scrub typhus-report of five cases. Indian J Med Res. 2019;149(6):790-94. doi:10.4103/ijmr.IJMR_1314_18
  7. Chung MH, Kang JS. Erythematous patch in tsutsugamushi disease-an atypical form of eschar. Infect Chemother. 2020;52(3):403-6. doi:10.3947/ic.2020.52.3.403
  8. Vanramliana, Pautu L, Lalmalsawma P, Rosangkima G, Sarma DK, et al. Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. PLoS Negl Trop Dis. 2023;17(11):e0011688. doi:10.1371/journal.pntd.0011688
  9. Nila SS, Paul SK, Kobayashi N, Nasreen SA, Ahmed S, Ahamad F, et al. Rapid serologic and molecular diagnosis of scrub typhus among suspected febrile patients visiting Mymensingh Medical College Hospital. Mymensingh Med J. 2021;30(4):967–72.
  10. Musa TH, Ahmad T, Wana MN, Li W, Musa HH, Sharun K, et al. The epidemiology, diagnosis and management of scrub typhus disease in China. Hum Vaccin Immunother. 2021;17(10):3795–805. doi:10.1080/21645515.2021.1934355.
  11. Lambden S, Laterre PF, Levy MM, Francois B. The SOFA score-development, utility and challenges of accurate assessment in clinical trials. Crit Care. 2019;23(1):374. doi:10.1186/s13054-019-2663-7
  12. Narlawar UW, Lilare RR, Gawande BS. Epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India. 2019;6(11):4867–9. DOI: https://doi.org/10.18203/2394-6040.ijcmph20195070
  13. Takhar RP, Bunkar ML, Arya S, Mirdha N, Mohd A. Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India. Natl Med J India. 2017;30(2):69–72.
  14. Narvencar KP, Rodrigues S, Nevrekar RP, et al. Scrub typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res. 2012;136(6):1020–4.
  15. Kumar R, Thakur S, Bhawani R, Kanga A, Ranjan A. Clinical profile and complications of scrub typhus: hospital-based study in Sub-Himalayan Region. J Assoc Physicians India. 2016;64(12):30-4.
  16. Varghese GM, Trowbridge P, Janardhanan J, Thomas K, Peter JV, Mathews P, et al. Clinical profile and improving mortality trend of scrub typhus in South India. Int J Infect Dis. 2014;23:39–43. doi:10.1016/j.ijid.2014.02.009
  17. Kamath SD, Kumari S, Sunder A. A Study of the profile of scrub typhus in a Tertiary Care Hospital in Jharkhand: an underestimated problem. Cureus. 2022;14(7):e26503. doi:10.7759/cureus.26503
  18. Bhattacharya PK, Murti VS, Jamil M, Barman B. Clinical profile and determinants of scrub typhus presenting with sepsis based on Sepsis-3 criteria. J Vector Borne Dis. 2020;57(4):307–13. doi:10.4103/0972-9062.313963
  19. Li W, Huang L, Zhang W. Scrub typhus with multi-organ dysfunction syndrome and immune thrombocytopenia: a case report and review of the literature. J Med Case Rep. 2019;13(1):358. doi:10.1186/s13256-019-2299-x
  20. Jamil M, Lyngrah KG, Lyngdoh M, Hussain M. Clinical manifestations and complications of scrub typhus: a hospital based study from North Eastern India. J Assoc Physicians India. 2014;62(12):19–23.




DOI: https://doi.org/10.15850/ijihs.v12.n1.3788

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