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.

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. 

Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome

2021 ◽  
Vol 14 (4) ◽  
pp. e242870
Author(s):  
Meenupriya Arasu ◽  
Nagalakshmi Swaminathan ◽  
Anusha Cherian ◽  
Magesh Parthiban
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Pregnant Patient ◽  
Lung Compliance ◽  
Pcr Assay ◽  
Oxygenation Indices

A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.

scholarly journals Severe Fever with Thrombocytopenic Syndrome: Current Epidemiological Situation

2021 ◽  
Vol 20 (4) ◽  
pp. 114-122
Author(s):  
E. I. Andaev ◽  
R. V. Adelshin ◽  
S. V. Balakhonov
Keyword(s):  
Rural Areas ◽  
Pacific Islands ◽  
Far East ◽  
Clinical Manifestations ◽  
Central China ◽  
Haemaphysalis Longicornis ◽  
Emerging Infections ◽  
North East ◽  
Severe Fever ◽  
Epidemiological Situation

Relevance. Severe fever with thrombocytopenia syndrome is a viral disease characterized by acute fever, accompanied by progressive thrombocytopenia, leucopenia. The mortality is up to 30%. The disease was first identified in 2009 in rural areas of central China, Hubei and Henan. The causative agent of the disease is a new Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV). The SFTSV is mainly transmitted through tick bites, especially Haemaphysalis longicornis which is the dominant tick species in East Asia.The aim of the review is to analyze relevant information about Severe Fever with Thrombocytopenia Syndrome, including the molecular genetics features of the pathogen, clinical manifestations, geographical distribution, epidemiological features, as well as the possibility of drift and spread of infection in the Russian Federation.Conclusions. SFTS is a serious health threat as it relates to new and re-emerging infections. The further spread of SFTS in China may complicate the epidemiological situation in the country. SFTSV may have a much wider global distribution in Southeast Asia than is currently known. The risk of H. longicornis ticks spreading is predicted in the north-east United States, New Zealand, parts of Australia and several Pacific islands. The presence of the H. longicornis in the Primorsky Territory on the Far East indicates a possible risk of the natural focus formation in the event of the introduction of the pathogen.

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.

Scrub typhus

2020 ◽  
pp. 1252-1257
Author(s):  
Daniel H. Paris ◽  
Nicholas P.J. Day
Keyword(s):  
Scrub Typhus ◽  
Disease Incidence ◽  
Multiorgan Failure ◽  
Febrile Illness ◽  
Maculopapular Rash ◽  
Obligate Intracellular ◽  
Tsutsugamushi Disease ◽  
Dead End ◽  
Diagnostic Difficulties ◽  
Transstadial Transmission

Orientia spp. are obligate intracellular Gram-negative bacteria that cause scrub typhus, historically known as ‘tsutsugamushi disease’, a febrile illness characterized by early non-specific ‘flu-like’ symptoms, and sometimes a diffuse, macular, or maculopapular rash and/or a necrotic lesion eschar at the inoculation site. Leptotrombidium mites transmit Orientia spp. to humans via the bite of the larval stage, while all mite stages act as bacterial reservoirs through vertical transovarial and transstadial transmission. Scrub typhus is a leading cause of treatable undifferentiated febrile illness in many regions of Asia, and unfortunately remains an underappreciated neglected disease, mainly due to diagnostic difficulties and lack of awareness among medical staff. Complications include meningo-encephalitis, respiratory and renal failure, and severe multiorgan failure. Scrub typhus can be treated effectively with tetracyclines, macrolides, and chloramphenicol. Humans are dead-end hosts and do not participate in the Orientia life cycle, hence treatment does not affect overall disease incidence.

scholarly journals Serological Detection and Epidemiological Factors Associated with Scrub Typhus among Undifferentiated Febrile Illness Patients in a Tertiary Care Hospital

2021 ◽  
Author(s):  
V.M. Somasunder ◽  
K. Akila ◽  
S. Sijimol ◽  
S. Senthamarai ◽  
S. Sivasankari ◽  
...  
Keyword(s):  
Rural Areas ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
P Value ◽  
Care Hospital ◽  
Serum Samples ◽  
Serological Tests ◽  
Igm Elisa

Scrub typhus is an arthropod-borne zoonotic bacterial infection caused by Orientia tsutsugamushi. It presents clinically as a non-specific febrile illness that needs a high index of clinical suspicion for diagnosis. The mortality rate can be as high as 30% if not treated appropriately. Laboratory diagnosis is therefore important for confirming the cause of illness prior to initiating appropriate therapy. Hence we aimed to detect scrub typhus in serum samples of undifferentiated febrile illness patients and to correlate with the socioeconomic status of these individuals. We also aimed to study the seasonal variation associated with the disease. Serum samples from 143 febrile patients who were negative for other febrile illnesses were subjected to scrub typhus IgM ELISA. Scrub typhus IgM antibodies were found in 14 (9.8%) individuals of which 41-60 years being the most affected age group. Scrub typhus positivity was high during the months of October to December (P-value 0.0056) with the individuals from the rural areas being the most affected (P-value 0.027). To conclude, this study emphasises the importance of serological tests to detect scrub typhus and to include it as a differential diagnosis among undifferentiated febrile illnesses.

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 A case of scrub typhus presenting as ARDS

2019 ◽  
Vol 10 (3) ◽  
pp. 2014-2016
Author(s):  
Ahmed Siddique A ◽  
Jagadeesan M ◽  
Mariraj I ◽  
Ramkumar M ◽  
Prasanna Karthik S1 ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Central Nervous System Involvement ◽  
Febrile Illness ◽  
Interesting Case ◽  
Systemic Spread

Acute respiratory distress syndrome (ARDS) is a disease, mainly occurring in critically ill patients. The systemic spread of infections mainly causes ARDS due to the seepage of fluid in the spaces of the lung . Scrub typhus is a infection caused by . The bite of mite transmits it. Scrub typhus is frequently due to its non-specific clinical presentation and relatively low level of suspicion in treating physicians. The clinical presentation of scrub typhus is varied from fever, , rashes, headache, to pneumonia, acute respiratory distress syndrome, sepsis, central nervous system involvement. The disease is usually indistinguishable from other febrile illness like enteric fever, disease, malaria and certain viral hemorrhagic fevers. Identification of an points to the diagnosis without which the diagnosis is based on a high index of clinical suspicion. We report an interesting case of scrub typhus presenting as acute respiratory distress syndrome.

scholarly journals Dengue fever and chikungunya virus infections: identification in travelers in Uganda – 2017

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
John T. Kayiwa ◽  
Annet M. Nankya ◽  
Irene Ataliba ◽  
Charity A. Nassuna ◽  
Isaac E. Omara ◽  
...  
Keyword(s):  
Public Health ◽  
Dengue Fever ◽  
Chikungunya Virus ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Final Diagnosis ◽  
Differential Diagnoses ◽  
Global Public Health ◽  
Emerging Viruses ◽  
Public Health Importance

AbstractArboviruses are (re-) emerging viruses that cause significant morbidity globally. Clinical manifestations usually consist of a non-specific febrile illness that may be accompanied by rash, arthralgia and arthritis and/or with neurological or hemorrhagic syndromes. The broad range of differential diagnoses of other infectious and non-infectious etiologies presents a challenge for clinicians. While knowledge of the geographic distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the non-specific and variable clinical presentation can delay final diagnosis. This case report summarizes the laboratory-based findings of three travel-related cases of arbovirus infections in Uganda. These include a patient from Bangladesh with chikungunya virus infection and two cases of dengue fever from Ethiopia. Early detection of travel-imported cases by public health laboratories is important to reduce the risk of localized outbreaks of arboviruses such as dengue virus and chikungunya virus. Because of the global public health importance and the continued risk of (re-) emerging arbovirus infections, specific recommendations following diagnosis by clinicians should include obtaining travel histories from persons with arbovirus-compatible illness and include differential diagnoses when appropriate.

scholarly journals Clinical Manifestations and Associated Complications of Scrub Typhus in Odisha, India

2020 ◽  
Author(s):  
Lalatendu Mohanty ◽  
Aditya Dhanawat ◽  
Partisha Gupta ◽  
Guncha Maheshwari
Keyword(s):  
Rural Areas ◽  
Scrub Typhus ◽  
Early Recognition ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Care Physician ◽  
Organ Systems

Introduction: Scrub typhus is a re-emerging illness in the South-East Asia and other parts of the world caused by Orientia tsutsugamushi, which is a mite-borne bacterium belonging to the Rickettsiaceae family. It has varied clinical manifestations and affects multiple organ systems. In Asia, about 1 million new cases are identified annually. Aim: The aim was to conduct a retrospective study to observe the clinical profile and complications of scrub typhus in South-Eastern India. Materials and Methods: Clinical data of 240 patients who were 18 years of age or above, admitted in the Department of Internal Medicine and diagnosed with scrub typhus by means of IgM Enzyme-linked Immune Sorbent Assay (ELISA) was collected. Demographic profile, clinical signs and symptoms, laboratory parameters, co-infections and complications were reviewed. Statistical analyses were performed using Chi-square test. Results: Majority of the patients were males, between the age of 18-29 years and lived in rural areas. Forty-three (17.9%) patients were admitted in the ICU and the remaining in wards. Sixty-nine (28.8%) patients had consolidation and 11 (4.6%) had Acute Respiratory Distress Syndrome (ARDS). Twenty-one (8.8%) patients had jaundice and 76 (31.7) had hepatomegaly. Twenty-one (8.8%) patients had meningo-encephalitis and 18 (7.5%) had acute kidney injury. Twelve (5%) patients had co-infection with dengue and 8 (3.3%) had malaria. Conclusion: This study shows wide and varied presentation of scrub typhus infection along with the course of the disease and response to the treatment. The diagnostic clues such as fever, eschar, rashes, lymphadenopathy should be kept in mind by a primary care physician as early recognition and treatment can prevent its dangerous complications and reduce the mortality due to the disease. Occurrence of co-infections should also be kept in mind for better management of the patient.

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