Presenting Features and Clinical Profile of Scrub Typhus Fever Cases in Adult Patients Admitted in a Tertiary Care Hospital in Puducherry, India

摘要

The infection of scrub typhus is caused by the bite of infected chiggers and the clinical manifestation of scrub typhus is characterised by the presence of fever, headache and body pain and rarely can causes rashes. There is paucity of information regarding the clinical presentation and the pathophysiological manifestation of scrub typhus infection, especially in tropical regions in Southern India.Aim: To determine the clinical profile and manifestation of scrub typhus infection among adults in Puducherry, India.Materials and Methods: This retrospective study was conducted on data of 79 IgM Immunochromatography (ICT) positive for scrub typhus patients, who were admitted and treated in 2015 in the study institution. Particulars regarding the clinical presentation, laboratory parameters and course in the hospital were documented from the medical records. Chi-square test was carried out to look for statistical significance between clinical and demographic parameters.Results: Fever was the predominant symptom (49.4%) followed by headache (38%) and cough (19%). Eschar was present in 16.4% of the participants, and it was predominantly located in hypochondrium, anterior abdominal wall and sacral region (15.4%). About 17.7% of the participants had abnormal respiratory signs, of which bilateral crackles with ronchi was the most common sign (64.4%). While most common complication was gastrointestinal (18.1%); multi-organ involvement was present in 11.4% of the participants. Participants >40 years of age increasingly presented with symptoms of Central Nervous System compared to younger age group (p<0.05).Conclusion: The features of febrile illness with low total count and thrombocytopenia with high index of suspicion for scrub typhus may prevent mortality due to multiorgan failure by early institution of treatment.