Publication:

Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

Background Scrub typhus is known from various parts of India. However, reports from central India are lacking. We performed pilot observation of confirmed scrub typhus cases from a single, tertiary care centre from central India.

Methods A retrospective analysis of 16 IgM ELISA confirmed scrub typhus cases was done. Clinical features, signs, laboratory parameters and complications were identified. Age ( 40 years) and gender (male versuss female) specific comparisons were performed. Data were analysed descriptively with appropriate statistical tests.

Results Diagnosed cases of scrub typhus were frequent in patients aged below 40 years (68.8) and in females (81.2%). Fever (100%), nausea±vomiting (68.8%) and headache (56.2%) were common symptoms. Rash was reported in a single case whereas characteristic eschar of scrub typhus was not observed in any patient. Mean hospital stay duration did not vary either by gender or by age-groups. Laboratory abnormalities did not show any significant deviation by gender or age analysis except mean haemoglobin being lower in females than males (10.1±1.4 Vs 12.3±1.1, p<0.05). Among various complications, anaemia (56.2%), thrombocytopenia (56.2%), elevated liver enzymes (37.5%) and pleural effusion (37.5%) were frequent. Overall, the number of complications were more in females (88.2%) and younger age (73.5%) groups. No deaths were seen in our set-up.

Conclusions Our pilot observation suggests scrub typhus is common in females and in younger age groups. These findings need further exploration in a large, prospective, trial in confirmed cases of scrub typhus.