Priyadarshini B1, Jayesh Kumar P2, Anitha P. M3
BACKGROUND
Scrub typhus is an underdiagnosed disease, but potentially treatable, if diagnosis is made with high index of suspicion. Deaths are attributable to late presentation, delayed diagnosis and drug resistance.
MATERIALS AND METHODS
The study was an observational study of prospective design conducted in the Department of General Medicine, Government Medical College, Kozhikode, over a period of one year. History, physical examination and relevant lab investigations were done in 70 patients in the study.
RESULTS
Majority of patients were in working class. Most common physical finding was lymphadenopathy. Eschar was present in 46% of patients. Majority responded to doxycycline. Case fatality was 14.3%.
CONCLUSION
1. Most cases occurred during cooler months of the year (Oct-Feb).
2. Fever and headache were the most common symptoms.
3. Lymphadenopathy was the most common sign followed by splenomegaly.
4. Eschar was present in 46% cases.
5. Leucocytosis was associated with poor prognosis and increased complication like meningoencephalitis.
6. Hypoalbuminaemia was associated with increased incidence of complications like myocarditis and encephalitis.
7. More than 2 times, elevation of transaminases was a poor prognostic marker.
8. Most common and important complication was Acute Kidney Injury (AKI).
9. Microangiopathic haemolysis could possibly be a contributory factor for high incidence of AKI associated with scrub typhus.
10. Rampant NSAID use is another contributory factor for high incidence of AKI associated with scrub typhus.
11. Resistance to doxycycline is emerging in our community and we should consider this possibility in cases with strong suspicion with no response to doxycycline.
KEYWORDS
Scrub Typhus, Febrile Thrombocytopenia, Eschar.
