To Determine the Clinical Profile and Manifestations of Scrub Typhus among People

Abstract

Introduction: In developing countries acute febrile illness (AFI) is the most common presenting complaint in emergency and outpatients department. Usually in the rainy season and post rainy season Outbreaks of AFI occur in India.  Outbreaks like Dengue, Malaria, Typhoid, Scrub typhus and several viral infections have been classically responsible. Orientia tsutsugamushi is an obligate intracellular gram negative bacteria which cause Scrub typhus. Scrub typhus is the infection caused by the bite of infected chiggers. The clinical manifestation is characterised by the presence of fever, body pain, headache and rarely can cause rashes. Scrub typhus is mite borne rickettsiosis and is an endaemic infection in area unique to Asia, with an estimated one billion people. In recent years, many parts of India scrub typhus have rapidly remerged to become the major cause of AFI during monsoon seasons. In India, of the 29 states, 23 have reported the presence of scrub typhus. Aim: The main aim of this study is to determine the clinical profile and manifestation of scrub typhus infection among people. Material and method: Total 72 patients with conform cases of scrub typhus fever were included in this study. The evaluation of fevers were undergone clinically initially serological test and Weil–Felix test followed by immunoglobulin M (IgM) scrub typhus and positive cases were included in this study. Consideration was taken of their clinical appearance and investigations. Results: Total 72 positive cases were included in this study. Among the total IgM positive for scrub typhus were analyzed with their age and sex variation. From each and every patient different clinical manifestations and complications were analyzed and recorded.  The common symptoms were fever; myalgia, breathlessness, rash, and abdominal pain were recorded as 100%, 66.7%, 8.3%, 13.9% and 36.1% respectively.  Renal failure was the most common complications followed by pneumonia as 19.4% and 9.7% respectively. In laboratory findings high C-reacting protein and leukocytosis are also found in 81.9% and 33.3% respectively.  Conclusion: Scrub typhus is a widespread tropical infection and often occurs as pyrexia of unknown origin. However sometime it is under diagnosed due to low indication of suspicion and due to non-specific clinical manifestation and also in most of clinical settings due to lack of diagnostic procedures. If there was early diagnosed then treatment will be easy and cost effective due to good response of antibiotics.