In Search of Scrub Typhus: A Prospective Analysis of Clinical and Epidemiological Profile of Patients from a Tertiary Care Hospital in New Delhi

Nitin Gupta; Rama Chaudhry; Sushil K. Kabra; Rakesh Lodha; Bijay R. Mirdha; Bimal K. Das; Naveet Wig; Vishnubhatla Sreenivas

doi:10.4236/aid.2015.54017

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Advances in Infectious Diseases > Vol.5 No.4, December 2015

In Search of Scrub Typhus: A Prospective Analysis of Clinical and Epidemiological Profile of Patients from a Tertiary Care Hospital in New Delhi ()

Nitin Gupta¹, Rama Chaudhry¹, Sushil K. Kabra², Rakesh Lodha², Bijay R. Mirdha¹, Bimal K. Das¹, Naveet Wig³, Vishnubhatla Sreenivas⁴

¹Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
²Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India.
³Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
⁴Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

DOI: 10.4236/aid.2015.54017 PDF HTML XML 3,927 Downloads 4,982 Views Citations

Abstract

Introduction: Scrub typhus is a febrile illness caused by Orientia tsutsugamushi which is transmitted by the larval stage of trombiculid mites. It has varied manifestations ranging from mild disease to fatal illness. The classical manifestations include fever, rash, lymphadenopathy and eschar. Serology is the preferred diagnostic tool with indirect immunofluorescence assay (IFA) as the current gold standard. Material & Methods: A total of 229 clinically suspected cases of Scrub typhus from 15^th of October 2013 to 15^th of October 2015 were enrolled in the study. Clinical, epidemiological and laboratory data of the patients were collected and analysed. The method for diagnosis was IgM immunofluorescence assay. Results: A total of 33 cases (14.4%) of scrub typhus were detected. Most of the cases (87%) presented in the months of September to November. Fever of >39°C was seen in all 33 cases. Rash and eschar were seen in 24.2% and 18.2% cases, respectively. Lymphadenopathy (18.2%), hepatomegaly (48.5%), splenomegaly (21.2%) and icterus (15.2%) were seen in some cases. Pulmonary manifestations were noted in 69.7% of cases. Acute kidney injury (18.2%), encephalitis (21.2%), and myocarditis (15.15%) were the other complications observed. Common haematological abnormalities noted in patients of scrub typhus were anaemia (45.6%), leucocytosis (45.6%), thrombocytopenia (48.5%) and transaminitis (54.5%). 10 cases were treated by azithromycin while doxycycline was used for treatment in 28 cases. Conclusion: The nonspecific symptoms and lack of classical manifestations make the diagnosis of scrub typhus difficult. There is a definite need to increase awareness and heighten the suspicion, especially in the light of increasing number of patients presenting with atypical manifestations.

Keywords

Scrub Typhus, India, Epidemiology

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Gupta, N. , Chaudhry, R. , Kabra, S. , Lodha, R. , Mirdha, B. , Das, B. , Wig, N. and Sreenivas, V. (2015) In Search of Scrub Typhus: A Prospective Analysis of Clinical and Epidemiological Profile of Patients from a Tertiary Care Hospital in New Delhi. Advances in Infectious Diseases, 5, 140-147. doi: 10.4236/aid.2015.54017.

Conflicts of Interest

The authors declare no conflicts of interest.

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