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ORIGINAL ARTICLE
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 62-65

Clinical manifestations and complications of scrub typhus: A study from tertiary care centre in Bihar


1 Assistant Professor, Dept. of Neurology, NMCH, Patna, India
2 PG Resident, Dept. of Medicine, NMCH, Patna, India
3 3Senior Resident, Ruban Patliputra Hospital, Patna, India
4 Medical Officer, Dept. of Medicine, Ruban Patliputra Hospital, Patna, India
5 Consultant, Dept. of Gastroenterology, Ruban Patliputra Hospital, Patna

Correspondence Address:
Anwar Alam
Assistant professor Dept. of Neurology, NMCH, Patna
India
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Source of Support: None, Conflict of Interest: None


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Background: Scrub typhus is a rickettsial infection that can be life threatening. There are several outbreaks of scrub typhus have been reported from different parts of India, but still clinicians are not much aware of this. We studied the diversity of clinical manifestations, laboratory investigations, complications and outcomes of scrub typhus in a tertiary care hospital. Materials and Methods: All the cases of acute febrile illness diagnosed as scrub typhus over a period of 10 months (march 2018 to December 2018) were analysed. Diagnosis was based on positive Weil-Felix with titre of ? 1:80. Results: A total of 13 cases of scrub were diagnosed and analysed during the study period. The most common symptoms among the patients were fever in 100% cases, headache, seizure and altered sensorium in 61.5% cases. Other symptoms were nausea, vomiting, breathlessness and urinary symptoms. The pathognomonic features such as eschar was seen in only one case (7%). On investigations, deranged liver function tests (LFT) were present in 61% of cases and deranged renal function tests (RFT) were present in 38% of patients. Thrombocytopenia (92%), meningoencephalitis (61%), acute respiratory distress syndrome (ARDS) (30%) were common complications of scrub typhus in this study. All patients responded dramatically to doxycycline and there was no mortality in this study. Conclusion:- Scrub typhus should be considered as an important differential diagnosis of acute febrile illness if it is associated with thrombocytopenia, deranged LFT and deranged RFT. Although eschar is pathognomonic of scrub typhus, even in the absence of eschar and lymphadenopathy a high index of suspicion and empirical addition of doxycycline is crucial for decreasing mortality.


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