scholarly journals Scrub typhus: as it stands today

2019 ◽  
Vol 7 (9) ◽  
pp. 3605
Author(s):  
Raman Sharma ◽  
Mayank Gupta ◽  
Sunil K. Mahavar ◽  
Madhulata Agarwal
Keyword(s):  
Scrub Typhus ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Late Presentation ◽  
Presumptive Treatment ◽  
Appropriate Treatment ◽  
Trombiculid Mite ◽  
Common Causes ◽  
Specific Symptoms

Scrub typhus is one of the three most common causes of prolonged fever in Southeast Asia and Pacific affecting almost 1 million people annually worldwide out of 1 billion exposed. Scrub typhus is a rickettsial infection caused by Orientia Tsutsugamushi transmitted through bite of Chiggers (larval stage of trombiculid mite). It is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure and death. Deaths are attributable to late presentation, delayed diagnosis, and drug resistance. Scrub typhus, though endemic in India; yet is under reported. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, and B/L chest opacities. Relapse is not uncommon. Presumptive treatment with Doxycycline can be a suitable option in febrile patients from Typhus pockets. Alert physician should keep an eye on deviation from usual presentation to changing spectrum of the disease. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

Cerebellitis as a rare manifestation of scrub typhus fever

2020 ◽  
Vol 13 (5) ◽  
pp. e233993
Author(s):  
Samiksha Gupta ◽  
Sahil Grover ◽  
Monica Gupta ◽  
Daljinderjit Kaur
Keyword(s):  
Scrub Typhus ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Uneventful Recovery ◽  
Cerebellar Dysfunction ◽  
Chigger Mite ◽  
Rickettsial Disease ◽  
Rare Manifestation ◽  
Typhus Fever

Scrub typhus is a mite-borne rickettsial disease caused by Orientia tsutsugamushi, a gram-negative coccobacilli transmitted through the bite of chigger mite. Scrub typhus has diverse clinical manifestations, often presenting either as a simple febrile illness or as a complicated multi-organ dysfunction. Neurological complications in scrub typhus are diverse but their exact incidence is unknown. Cerebellitis is another rare neurological manifestation associated with scrub typhus. Here, we report the case of a 26-year-old woman with serologically confirmed scrub typhus presenting with fever and gross cerebellar dysfunction. MRI was normal. She was managed with antimicrobials and made an uneventful recovery.

scholarly journals Dengue and Scrub Typhus Coinfection in a Patient Presenting with Febrile Illness

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Surendra Sapkota ◽  
Sudeep Bhandari ◽  
Subash Sapkota ◽  
Rabin Hamal
Keyword(s):  
Dengue Fever ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Laboratory Parameters ◽  
Vector Borne Diseases ◽  
Common Causes ◽  
Vector Borne ◽  
High Degree ◽  
Timely Treatment

Dengue fever and scrub typhus are common causes of acute febrile illness of unclear origin in Asia. Though coinfections of many vector-borne diseases have been described, articles on dengue and scrub typhus coinfection are distinctly limited. In case of coinfection with dengue and scrub typhus, vigilant monitoring of vitals, platelets transfusion, and timely treatment with doxycycline are necessary. High degree of suspicion has to be made for coinfection in a patient presenting with febrile illness with thrombocytopenia and deranged laboratory parameters in postmonsoon season in endemic regions in Asia.

scholarly journals FatalPlasmodium falciparum,Clostridium perfringens, andCandida spp.Coinfections in a Traveler to Haiti

2009 ◽  
Vol 2009 ◽  
pp. 1-6
Author(s):  
Gillian L. Genrich ◽  
Julu Bhatnagar ◽  
Christopher D. Paddock ◽  
Sherif R. Zaki
Keyword(s):  
Plasmodium Falciparum ◽  
Clostridium Perfringens ◽  
Fungal Pathogens ◽  
Febrile Illness ◽  
Malaria Treatment ◽  
Molecular Techniques ◽  
Candida Spp ◽  
Secondary Infections ◽  
Appropriate Treatment ◽  
Common Causes

Malaria is one of the most common causes of febrile illness in travelers. Coinfections with bacterial, viral, and fungal pathogens may not be suspected unless a patient fails to respond to malaria treatment. Using novel immunohistochemical and molecular techniques,Plasmodium falciparum,Clostridium perfringens, andCandida spp.coinfections were confirmed in a German traveler to Haiti.Plasmodium falciparum-induced ischemia may have increased this patient's susceptibility toC. perfringensand disseminated candidiasis leading to his death. When a patient presents withP. falciparumand shock and is unresponsive to malaria treatment, secondary infections should be suspected to initiate appropriate treatment.

scholarly journals Scrub typhus, a reemerging zoonosis – An Indian case series

2014 ◽  
Vol 5 (3) ◽  
pp. 108-111 ◽  
Author(s):  
Deepak Madi ◽  
Basavaprabhu Achappa ◽  
M Chakrapani ◽  
MR Pavan ◽  
Saaritha Narayanan ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Medical Science ◽  
Clinical Manifestations ◽  
Case Series ◽  
Febrile Illness ◽  
Rickettsial Disease ◽  
Study Results ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Rickettsial Diseases

Background: Rickettsial diseases are reemerging in many parts of our country. Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi. It is difficult to diagnose Scrub typhus because of nonspecific clinical presentation and lack of availability of specific tests (ELISA) in all centres. Aim: Our aim was to study the clinical features, lab parameters and outcome of patients diagnosed with Scrub typhus. Materials and Methods: A retrospective hospital based study was done in Mangalore (Karnataka) to identify cases of scrub typhus. Patients who had an acute febrile illness and IgM antibodies against O. tsutsugamushi were included in our study. Results: 10 cases of Scrub typhus were identified. Among them 7(70%) patients were females and 3(30%) were males. Major symptoms on admission were fever10(100%), dyspnea or cough-2(20%), rashes1(10%), altered sensorium1(10%). The major signs were fever10(100%), eschar 2(20%), and signs of meningial irritation in 1(10%). Lab parameters showed leukocytosis in 4(40%), thrombocytopenia in 3(30%), raised liver enzymes in 3(30%) and renal failure in 3(30%). Chest X-ray showed consolidation in 2(20%) patients. There was no mortality in our study. Conclusion: Scrub typhus can present with varying clinical manifestations and eschar can be absent in majority of cases as shown in our study. Therefore diagnosis should be based on a high index of suspicion and empirical treatment with doxycycline must be started whenever there is a strong suspicion of Scrub typhus. Asian Journal of Medical Science, Volume-5(3) 2014: 108-111 http://dx.doi.org/10.3126/ajms.v5i3.9213  

scholarly journals Hyperferritinemia in children hospitalized with scrub typhus

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Vijai Williams ◽  
Nisha Menon ◽  
Prateek Bhatia ◽  
Manisha Biswal ◽  
Sreejesh Sreedharanunni ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Secondary Analysis ◽  
Febrile Illness ◽  
Late Presentation ◽  
North India ◽  
Risk Scores ◽  
Early Presentation ◽  
Igm Elisa

Abstract Background Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited. Methods This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching hospital in North India where 72 children with confirmed scrub typhus, 4 (5.5%) PCR positive, 55 (76.4%)-IgM ELISA positive, and 13 (18.1%)-both PCR and ELISA positive, were analyzed. Serum ferritin was measured in 62 children to identify the prevalence of hyperferritinemia and determine its association with mortality. Results Hyperferritinemia (> 500 μg/L) was seen in 72.6% [n = 45] children; 26 (41.9%) were mild (500–2000 μg/L), 13 (21%) were moderate (2000–10,000 μg/L), and 6 (9.7%) were severe (> 10,000 μg/L). Early presentation to hospital (≤ 7 days of febrile illness) had more survivors than late presentation (> 7 days). Non-survivors had significantly higher PRISM III, PELOD-2, hyperlactatemia, hypoalbuminemia, organ dysfunction, need for mechanical ventilation, and need of RRT. Ferritin had poor sensitivity and specificity in predicting survival with AUC of 0.56. Organ dysfunction and risk scores as PRISM III, PELOD 2, and VIS at admission were better predictors with AUC (95% CI) of 0.72 (0.56, 0.89), 0.77 (0.63, 0.92), and 0.90 (0.78, 1.0) respectively. Conclusions Hyperferritinemia is common in scrub typhus but it did not predict survival. Organ dysfunction and risk scores were better predictors of mortality than ferritin.

scholarly journals Clinicoetiological profile and outcome of acute febrile illness with thrombocytopenia in children: a hospital based prospective study

2020 ◽  
Vol 7 (6) ◽  
pp. 1284
Author(s):  
Priyanka Agarwal ◽  
Ratan Kumar Das ◽  
Dillip Kumar Dash ◽  
Mamta Kumari ◽  
M. D. Mohanty
Keyword(s):  
Prospective Study ◽  
Scrub Typhus ◽  
Correct Diagnosis ◽  
Febrile Illness ◽  
Female Child ◽  
Routine Practice ◽  
Severe Thrombocytopenia ◽  
Age Group ◽  
Appropriate Treatment ◽  
A Prospective Study

 Background: Thrombocytopenia is often the most commonly encountered clinical condition in this routine practice. Etiological causes being numerous, often pose a challenge in evaluating and treating the patients. The objective of this study was to find out the different causes and clinical profile of fever with thrombocytopenia in children aged 1month to 14 year who were admitted in this set up.Methods: This was a prospective study done on 200 patients with thrombocytopenia admitted IMS AND SUM Hospital, BBSR with various complaints, during the period of 01 August 2017 to 01 August 2019. This study includes age group 1months to 14 years.Results: The highest incidence of thrombocytopenia belonged to the age group 11-14 years (22.5%) followed by 6-9 years (19.5%) and 3-6 years (18%). Incidence of thrombocytopenia was more in male child (58.5%) as compared to female child (41.5%). the most common cause of thrombocytopenia was dengue (50%), Scrub typhus (34%) septicaemia (17.5%) followed by malaria (10.5%). Among the infectious aetiology severe thrombocytopenia was seen more in dengue (25%) and scrub typhus (34.5%) but evidence of bleeding was seen more in sepsis (34.2%) even with higher platelet count which may be explained by associated multi organ failure.Conclusions: Infections like malaria, dengue, leptospirosis and septicaemia were the common causes of thrombocytopenia along with scrub typhus. Whenever thrombocytopenia is detected further investigations can help us in reaching a correct diagnosis in the majority of the cases so that appropriate treatment can be given and also to avoid unnecessary platelet transfusion to prevent transfusion related complications.

Scrub typhus and lateral rectus palsy: an uncommon presentation of a common illness

2021 ◽  
Vol 14 (5) ◽  
pp. e240882
Author(s):  
Ajay Chauhan ◽  
Aditya Jandial ◽  
Kundan Mishra ◽  
Rajeev Sandal
Keyword(s):  
Scrub Typhus ◽  
Clinical Manifestations ◽  
Central Nervous System Involvement ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
Cranial Nerve Involvement ◽  
Uncommon Presentation ◽  
Life Threatening ◽  
Multiorgan Dysfunction Syndrome

Scrub typhus is a zoonosis, which usually manifests as an acute febrile illness. It is caused by a rickettsia, Orientia tsutsugamushi, which is endemic in the Asian region. It can present with varied clinical manifestations, ranging from acute febrile illness to life-threatening multiorgan dysfunction syndrome. Central nervous system involvement in the form of altered sensorium and/or meningitis is frequently observed in scrub typhus. However, isolated cranial nerve involvement is uncommon and so far only a few such cases have been reported in the literature. We present a rare case of scrub typhus with fever and diplopia at presentation, which completely improved with doxycycline-based treatment.

scholarly journals Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus

2017 ◽  
Vol 2 (1) ◽  
pp. 35-37
Author(s):  
CM Agrawal ◽  
Manish R Pahadia ◽  
Shubham Gupta ◽  
Haritej Anand
Keyword(s):  
Rural Areas ◽  
Pacific Islands ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Public Health Importance ◽  
Obligate Intracellular ◽  
Subclinical Disease ◽  
Rare Phenomenon

ABSTRACT Introduction Scrub typhus is an acute, febrile zoonosis, caused by an obligate intracellular bacterium Orientia tsutsugamushi. The disease is of greatest public health importance in rural areas of Asia and in Western Pacific Islands. The clinical manifestations of the disease range from subclinical disease to an organ failure. The various complications known with this disease are jaundice, renal failure, pneumonitis, acute respiratory distress syndrome, septic shock, myocarditis, vasculitis, and meningoencephalitis. The complications of scrub typhus usually develop after the first week of illness. Case report We report a case of a 70-year-old female, farmer by occupation, who presented with acute febrile illness and was diagnosed as scrub typhus. She subsequently developed vasculitis, which resulted in pan digital gangrene. After thorough workup for digital gangrene, it was established that scrub typhus is the cause of gangrene in this patient. Conclusion Thus, our inference is that vasculitis might be seen in very few cases of scrub typhus and it may progress up to gangrene of digits. Only one such case has been reported, thus making it a very rare phenomenon. How to cite this article Rijhwani P, Charan A, Agrawal CM, Pahadia MR, Gupta S, Anand H. Pan Digital Gangrene: A Rare Phenomenon in Scrub Typhus. J Mahatma Gandhi Univ Med Sci Tech 2017;2(1):35-37.

scholarly journals Clinical and laboratory profile of Scrub typhus in paediatric age group

2020 ◽  
Vol 11 (6) ◽  
pp. 63-67
Author(s):  
Atindra Mishra ◽  
Rupa Thakur ◽  
Ruby Thakur
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Care Hospital ◽  
Age Group ◽  
Open Defecation ◽  
Laboratory Findings ◽  
Laboratory Profile

Background: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, obligate intracellular organism. Incidence of Scrub typhus is increasing due to easy availability and decreased cost of diagnostic facility. This study was designed to study the clinical and laboratory profile of scrub typhus patient in department of paediatrics at National Medical College, Birgunj. Aims and Objectives: To study the clinical manifestations, laboratory findings and complications of Scrub typhus in Pediatric age group. Methods and Methods: A prospective observational study was carried out in children below the age of 15 years, admitted in paediatrics department of a tertiary care hospital of Nepal from June 2019 to May 2020. Clinical manifestations and laboratory findings were collected and recorded in predesigned data sheet. Scrub typhus was diagnosed with IgM ELISA. Results: A total of 52 patients were diagnosed as scrub typhus. All patients presented with fever and commonly had other symptoms such as headache (65.3%), vomiting (63.5%), cough (59.6%), breathing difficulty (57.7%), abdominal pain (53.9%), seizures (21.2%) and rashes (9.6%). Important clinical signs noticed were lymphadenopathy (84.6%), edema (76.4%), hepatomegaly (56.8%), splenomegaly (36.5%) jaundice (30.7%). About 12% (n = 9) had necrotic eschar. 54% of the admitted patient confirmed using open defecation. Myocarditis (67.3%) was the commonest complication followed by Acute Kidney Injury (65.4%). Conclusions: Scrub typhus must be considered in differential of tropical fever in children, especially in those residing in rural area and having open defecation. In our study, Fever was the ubiquitous symptom and Myocarditis was the commonest complication.

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