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Category: Volume 09 Issue 02 February 2021
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Title: Clinical Manifestations and Complication Associated with Scrub Typhus with and without Eschar in a tertiary care Hospital, South India

Authors: Dr Chandana Kaspa, Dr Abhinay Shankar Govindu

 DOI: https://dx.doi.org/10.18535/jmscr/v9i2.20

Abstract

Introduction: Scrub typhus, also known as tsutsugamushi disease, is caused by the arthropod-borne gram-negative obligately intracellular bacillus Orientia tsutsugamushi. It is a re-emerging infectious disease in India and has gained clinical importance because of its effect on multiple organ systems and progression to various complications, when not detected early and managed appropriately. The present study was conducted in a Tertiary Care Hospital in South India with an objective to study the severity of scrub typhus to presence of Eschar.

Methodology: A Cross sectional study was conducted in a Tertiary Care Hospital in South India during August 2019 to January 2020 where 200 adult patients who presented with an acute undifferentiated febrile illness and confirmed to have Scrub Typhus were included in the study.

Results: The mean age of the study participants in Eschar group was 46.68 ± 14.69 and the mean age among the participants without Eschar was 48.86 ± 14.71. Agricultural work was found to be predominant occupation in both the group50% of the patients in Eschar group had Co-morbidities out of which 28% had Diabetes 14% had Hypertension, 8% had CAD where as in the Non-Eschar group, 41% were with Co-morbidities out of which, 19% were Diabetic, 15% were Hypertensive, 7% had a history of CAD. In our study among the Eschar group 5% Patients showed CNS manifestations and it was statistically significant when compared to non eschar group.

Conclusion: Eschar in patients with Scrub Typhus is significantly associated with a higher incidence of renal, respiratory system and CNS involvement. Hence early identification and early intervention play a key role in management of the patient.

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Corresponding Author

Dr Chandana Kaspa

Assistant professor, Department of General Medicine, Guntur Medical College