Clinical profile and determinants of scrub typhus presenting with sepsis based on Sepsis-3 criteria

Background: Scrub typhus is an important cause of acute undifferentiated fever. It is currently one of the most covert re-emerging infections and the most common rickettsial infection caused by Orientia tsutsugamushi. Untreated cases can have mortality rates as high as 30-35%. Objectives: This study was done to study demographical data, clinical profile, and predictors of outcome for scrub typhus in children who were admitted to our institution, a tertiary care hospital in south India. Methods: In this retrospective study, children diagnosed with scrub typhus based on IgM enzyme-linked immunosorbent assay (ELISA), between January 2012 and June 2019 were included. Detailed history, clinical examination findings, laboratory profile, complications, and outcome were analyzed. Results: A total of 120 patients were identified, of whom 84 (42 males- and 42 females) cases satisfied the inclusion criteria and were analyzed. About 80 (95%) cases had a complete recovery, whereas 4 patients (5%) died of multiple complications. Hypotension, hypoxia, altered sensorium, hypoalbuminemia, elevated liver enzymes, azotemia, and deranged coagulation on admission were considered as poor predictors of outcome for scrub typhus. Conclusions: Pediatric scrub typhus is a common infection and should be suspected in cases with fever for more than 5 days and non-specific signs and symptoms. Early detection and timely management lead to a higher recovery rate. Hypotension, hypoxia, azotemia, altered sensorium, and bleeding manifestations on admission were associated with unfavorable outcomes.

Download Full-text

Epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20195070 ◽

2019 ◽

Vol 6 (11) ◽

pp. 4867 ◽

Cited By ~ 1

Author(s):

Uday W. Narlawar ◽

Rushali Rajan Lilare ◽

Bhagyashree S. Gawande

Keyword(s):

Rural Areas ◽

Scrub Typhus ◽

Indian Subcontinent ◽

Tertiary Care ◽

Central India ◽

Clinical Profile ◽

Care Centre ◽

Tertiary Care Centre ◽

Altered Sensorium ◽

Presenting Symptoms

Background: Scrub typhus is the most common rickettsial infection in the Indian subcontinent with the manifestation ranging from mild symptoms to serious disease with or complication or death. The objective of this study was to study epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India.Methods: Present study is a record based retrospective study enrolling 173 confirmed positive cases with ELISA test during the period from 1st August to 31st December 2018.Results: Maximum number of the cases 94 (54.3%) had occurred in September 2019. Majority of the female 94(54.3%) were Ig M positive for scrub typhus. Maximum cases 134 (77.5%) were from rural area. Most common symptoms were fever 170 (98.3%), followed by fever with chills 65 (37.6%), breathlessness 49 (28.3%), cough 35 (20.2%), and 28 (16.2%) each with altered sensorium and headache. Mortality was recorded in 30 (173%) and amongst them 10 (34.5%) and 4 (13.8%) cases had ARDS and septicaemia as complication respectively.Conclusions: This study shows that majority of the cases occurred in the month of September 2018 with female preponderance. Most of the residence were from rural areas with common presenting symptoms as fever or fever with chills followed by breathlessness, cough and altered sensorium and headache.

Download Full-text

717: CLINICAL PROFILE AND RISK FACTORS FOR SEVERE SCRUB TYPHUS IN CHILDREN REQUIRING PICU ADMISSION

Critical Care Medicine ◽

10.1097/01.ccm.0000809192.03697.f4 ◽

2021 ◽

Vol 50 (1) ◽

pp. 352-352

Author(s):

Samriti Gupta ◽

Juhi Sheekha ◽

Milap Sharma

Keyword(s):

Risk Factors ◽

Scrub Typhus ◽

Clinical Profile

Download Full-text

Clinical profile and outcome of patients admitted to pediatric intensive care unit in a tertiary care teaching hospital of Puducherry, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202134 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1280

Author(s):

Maheswari K. ◽

Neha Sharma

Keyword(s):

Electric Shock ◽

Scrub Typhus ◽

Tertiary Care ◽

Age Distribution ◽

Acute Otitis Media ◽

Clinical Profile ◽

Research Centre ◽

College Hospital ◽

Care Teaching ◽

Common Diagnosis

Background: This study was undertaken to know about the clinical profile and outcome of patients admitted in paediatric ICU in a tertiary care teaching hospital.Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to paediatric ICU of Sri Venkateshwara Medical College Hospital and Research Centre Puducherry from Jan 2019 - Dec 2019 (12 months).Results: As about 424 patients were admitted paediatric ICU. 79 patients were excluded from the study. Remaining 345 PICU patients were analysed. According to the age distribution of patients, it showed that < 1year were (25.2%), 1-5 years were (44.3%), > 5years of age were (30.4%). There was a female preponderance (58.8%), males were (41.1%). Patients from rural area were 243 (70.4%) and 102 (29.5%) from urban area. Clinical profile showed that pneumonia was the most common diagnosis (8.4%) for admission in PICU. This was followed by bronchiolitis (6.9%), enteric fever in (6.6%), febrile seizures (6.3%), poisoning (6.0%), renal problems (5.7%), occult bacteremia (5.5%), unknown bite (5.2%), acute severe asthma (4.9%), sepsis (4.6%), severe gastritis (4.3%), clinical dengue (3.7%), seizure disorder (3.4%), croup (3.1%), traumatic head injury (2.8%), wheeze associated LRI (2.6%), acute otitis media (2.3%), migraine (2.0%), meningitis (1.7%), CHD with complications (1.7%), severe anaemia with CCF (1.4%), acute urticarial (1.4%), foreign body (1.1%), electric shock (1.1%), scorpion sting (0.8%), viral hepatitis (0.8%), clinical malaria (0.8%), nephrotic syndrome with complications (0.5%), scrub typhus (0.2%) and (0.2%) was angioedema. The outcome noted was, (87.8%) were discharged, (10.7%) patients went against medical advice, (1.4%) patients were referred at parent’s request.Conclusions: Respiratory illness, infectious diseases, neurological problems and poisoning are the most common cause for PICU admissions. But seronegative dengue cases, electric shock, reemergence of scrub typhus, are being increasingly diagnosed. So, emphasis is therefore placed on high index of suspicion for this type of conditions. We also recommend better manpower and infrastructure to improve the outcome of patients admitted to PICU.

Download Full-text