Clinical profile and risk factors associated with severe scrub typhus infection among non-ICU patients in semi-urban south India.

This study was aimed to report the clinical profile, complications and risk factors associated with severe illness in patients with scrub typhus, outside the intensive care setting. Methods: It was a prospective study, which involved recruitment of patients with acute febrile illness and diagnosed to have scrub typhus, who were admitted to the general medical wards of a tertiary care centre in Kanchipuram district, in semi-urban south India, over a 12 month period between June 2015 and May 2016. The diagnosis was established both clinically (with or without pathognomonic eschar) and by a positive test of IgM antibodies against scrub typhus by ELISA. The severity of scrub typhus was determined by the presence of organ dysfunction, and the factors associated with it were analyzed. Results: A total of 50 patients with mean age of 39.6±20.5 yr (mean ± SD) were admitted. The mean duration of illness before presentation was 9.10 ± 8.6 days. The mean duration of hospital stay was 7.7±3.6 days. The symptoms included fever, abdominal symptoms, headache, dysuria, breathlessness and altered sensorium. Most common findings on physical examination were eschar (58%), crepitations in the chest (36%), hepatomegaly (34%) and lymphadenopathy (30%). Thirty two percent had respiratory complications, 4% required mechanical ventilation, 24% had shock, 16% had acute kidney injury, and 6% had dysfunction of ≥2 organs. Age of >50 yr, longer duration of illness (>7 days), r...
Source: Journal of Vector Borne Diseases - Category: Infectious Diseases Tags: J Vector Borne Dis Source Type: research