Coagulation Abnormalities in Severe Scrub Typhus and Their Association with Complications.

Aim: To describe coagulation abnormalities and their association with complications in patients with severe scrub typhus.

Materials And Methods: A cohort study was conducted among all patients of severe scrub typhus [immunoglobulin M (IgM) positive] who reported to this facility from 1st August 2019 to 31st July 2020 and met our inclusion criteria. We estimated the incidence of severe thrombocytopenia (<50,000/µL) and overt disseminated intravascular coagulation (DIC) (DIC score of ≥5).

Intravenous Doxycycline, Azithromycin, or Both for Severe Scrub Typhus.

Background: The appropriate antibiotic treatment for severe scrub typhus, a neglected but widespread reemerging zoonotic infection, is unclear.

Methods: In this multicenter, double-blind, randomized, controlled trial, we compared the efficacy of intravenous doxycycline, azithromycin, or a combination of both in treating severe scrub typhus. Patients who were 15 years of age or older with severe scrub typhus with at least one organ involvement were enrolled.

Is Hyperuricemia a Marker of Severity of Disease in Scrub Typhus?

Aims: To study association of hyperuricemia with severity of scrub typhus.

Methods: We studied clinical features, laboratory profile, in hospital course and outcome of 92 patients of scrub typhus and association of hyperuricemia with severity of disease.

Results: Of total 92 patients in study group, 66 (71.

Heerfordt-Waldenström Syndrome.

Heerfordt's-Waldenström syndrome is a very rare presentation of neurosarcoidosis characterized by parotid gland enlargement, facial palsy, anterior uveitis and fever. World over only few cases of this syndrome have been reported. We present such a case of Heerfordt-Waldenström syndrome.

Predictors of Severity in Scrub Typhus.

Aims: To study predictors of severity in patients of scrub typhus admitted in a tertiary care hospital.

Material And Methods: Total 92 patients of scrub typhus were included in the study. The diagnosis was established by presence of IgM antibodies by Indirect Immunofluorescence Assay (IFA) test which is currently the reference standard for the diagnosis of scrub typhus.

The Evolving Pattern and Outcome of Stroke at Moderate Altitude.

Background: The people residing in hills of this Sub-Himalayan region traditionally have a distinct lifestyle involving high level of physical activity. However, increased urbanization in the last two decades has led to changes in lifestyle of people. The present study was an endeavor to document changes in the pattern of stroke in people residing at moderate altitude.

Neuropsychiatric Manifestations of Scrub Typhus.

Scrub typhus is caused by characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India.

Pattern of Clinical Presentation, Laboratory Findings and Mortality Risk Among Patients of Scrub Typhus in Western Himalayas.

Objective: To study the pattern of the clinical presentation, laboratory findings and mortality risk among patients infected by scrub typhus in Western Himalayan region of India.

Methods: We studied all serologically confirmed cases of scrub typhus admitted to our hospital from July 2010 through December 2011. Presence of IgM antibodies to scrub typhus antigens by ELISA was considered as serological confirmation of the diagnosis.

Scrub Typhus Presenting as Acute Cerebellitis.

Scrub typhus is known to present with varied presentation including involvement of central nervous system. We present a case who presented with fever and features of isolated cerebellitis. Serum showed IgM antibodies to scrub typhus by ELISA.

Neurological manifestations of scrub typhus in adults.

In order to study the neurological manifestations in adult patients suffering from scrub typhus, 323 patients aged over 18 years, admitted with a positive diagnosis, were screened for neurological dysfunction; 37 patients with symptoms and/or signs suggestive of neurological dysfunction were included in the study. Of these, 31 (84%) patients had altered sensorium, four (11%) had cerebellitis, one (2%) patient had acute transverse myelitis and one (2%) had bilateral papilloedema without focal neurological deficit. Of the 31 patients with altered sensorium, 15 (40%) had meningoencephalitis, three (8%) had seizures, two (5%) had cerebral haemorrhages, one (2%) had a presentation likened to neuroleptic malignant syndrome (NMS) and one (2%) had a 6th nerve palsy with inflammation of the right cavernous sinus.

Neurobrucellosis: an often forgotten cause of chronic meningitis.

We report a 26-year-old man of neurobrucellosis who presented with intermittent fever and headache for 2 years, sensori-neural hearing loss with cerebellar ataxia. He responded well to a combination of antimicrobials with significant clinical improvement.

Scrub typhus with visual hallucinations.

The occurrence of psychiatric symptoms in scrub typhus is not commonly reported in literature. We present a case of scrub typhus with visual hallucinations.

Molecular epidemiology and genetic diversity of Orientia tsutsugamushi from patients with scrub typhus in 3 regions of India.

Scrub typhus, an acute febrile illness that is widespread in the Asia-Pacific region, is caused by the bacterium Orientia tsutsugamushi, which displays high levels of antigenic variation. We conducted an investigation to identify the circulating genotypes of O. tsutsugamushi in 3 scrub typhus-endemic geographic regions of India: South India, Northern India, and Northeast India.

Scrub typhus and malaria co-infection causing severe sepsis.

We report a case of dual infection of scrub typhus and malaria in a 48-year-old woman.

Rickettsial diseases.

Rickettsiae are a rather diverse collection of organisms with several differences; this prohibits their description as a single homogenous group. Rickettsiae are maintained in nature through a cycle involving reservoir in mammals and arthropod vectors. The public health impact of these on lives or productivity lost is largely unmeasured, but suspected to be quite high worldwide.

Scrub typhus and leptospirosis co-infection in Himalayan region.

Scrub typhus and leptospirosis are both zoonosis and systemic febrile illnesses with diverse clinical manifestations and they may present with similar signs and symptoms. We present a case of co-infection of scrub typhus and leptospirosis from Himachal Pradesh in the Himalayan region of India.

Scrub typhus presenting as acute abdomen.

Scrub typhus, a zoonosis, is a systemic febrile illness with diverse clinical manifestations. It may also present with signs and symptoms of acute abdomen. We present two serologically confirmed cases of scrub typhus presenting with acute abdomen that were managed conservatively with antibiotics.

Pediatric scrub typhus in Indian Himalayas.

To retrospectively confirm the suspected rickettsial disease (Scrub typhus) using a gold standard diagnostic test i.e. microimmunofluorescence in pediatric patients with acute febrile illness of unknown etiology.

Development of a real-time PCR assay for the diagnosis of scrub typhus cases in India and evidence of the prevalence of new genotype of O. tsutsugamushi.

A qualitative syber green real-time PCR with primers designed for a truncated portion of the 56kDa major outer membrane antigen gene of Orientia tsutsugamushi was used to diagnose scrub typhus from the blood or serum of suspected patients. Sixty-six blood and/or sera samples from fever cases, either with high index of suspicion for scrub typhus and/or positive by Weil-Felix test (> or = 1:160), were tested with the PCR. Specificity of the PCR was confirmed by end point melt curve analysis and sequencing of the amplicons.