Clinico-laboratory profile of scrub typhus from mid and lower Himalayan region in north India

Abstract

Aim

To describe the clinico-laboratory profile of scrub typhus diagnosed in a tertiary care institution in northern India.

Materials and methods

All cases of febrile illness diagnosed as scrub typhus over a period of 6 months were analyzed retrospectively. Diagnosis was based on positive IgM ELISA.

Results

Forty-four cases of scrub typhus were seen over a period of 6 months (July 2013 and December 2013). Common clinical features were fever (100%), lymphadenopathy (68.18%), hepatomegaly (56.82%), splenomegaly (47.73%), vomiting (38.64%), signs of meningeal irritation (38.64%), abdominal pain (31.82%), hypotension (31.82%), pedal edema (29.54%), rash (20.45%), and cough (11.36%). Eschar was seen in 10 (22.73%) cases. Common laboratory findings were thrombocytopenia (68.18%), increased liver enzymes (40.9%), meningitis (34.1%), leucocytosis (34.1%), and azotemia (22.73%). Multiple organ dysfunction syndrome (MODS) was present in 24 (54.54%) patients, shock in 15 (34.1%), meningitis in 15 (34.1%), ARDS in 11 (25%), hepatitis in 11 (25%), and azotemia in 10 (22.73%) patients. A total of 3 (6.82%) patients died.

Conclusion

Scrub typhus has emerged as an important cause of febrile illness with multisystemic involvement and high rate of MODS.