Clinical Profile and Treatment Outcome in Scrub Typhus Patients in Central India.

Background: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. It is known from various parts of India. However Central India was naive to any epidemics of scrub typhus with occasional and sporadic occurrence now and then. This part of India witnessed an outbreak of scrub typhus in the months of August and September 2018. Therefore present research was carried out with an objective to study the clinical profile and treatment outcome in scrub typhus patients in central India.

Method: In this study, total 140 patients with an acute febrile illness diagnosed as scrub typhus by positive IgM antibodies against O. tsutsugamushi were enrolled, over a period of two months (August to October 2018). All relevant data were recorded and analyzed.

Results: Among 140 cases, 52.14% patients reported from urban area and 47.85% patients from rural area. The mean age of patients was 43.75±16.82 years, ranged from 12-83 years with female predominance (male: female-1:1.37). Fever (100%), cough (38.57%) breathlessness (27.85%), altered sensorium (9.28%) and headache (7.85%) were the predominant clinical features. Eschar was seen in 33 patients (23.57 %). Renal (73; 52.14%) and hepatic dysfunction (68; 48.57%) was the commonest followed by respiratory dysfunction (59; 42.14%). All patients (except pregnant patients) were treated with oral or inj doxycycline. Seventeen patients needed mechanical ventilation and five patients required dialysis. Total 24 (17.14%) patients died during the study period.

Conclusion: Scrub typhus has become a leading infectious disease in central India and an important cause of infectious fever. An increasing awareness of this disease coupled with prompt management will go a long way in reducing both morbidity and mortality from this disease.