Affiliation:
1. MD, Assistant Professor, Department of Microbiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly – 243202 ( U. P.).
2. MD, Professor, Department of Microbiology, SRMS IMS, Bareilly
Abstract
BACKGROUND: Scrub typhus(ST) a rickettsial infection caused by Orientia tsutsugamushi and transmitted by
trombiculid mites“chiggers” particularly Leptotrombidium deliense. It is one of the differential diagnoses of
haemorrhagic fevers, especially if associated with acute respiratory distress syndrome and/or jaundice. A necrotic eschar at the inoculating site of
the mite is pathognomic of ST.The western Himalayan regions of India, has been witnessing increased incidence of acute febrile illnesses over
the years.
AIM & OBJECTIVES : 1) To determine the frequency of ST in a tertiary health care hospital in Uttarakhand. 2) To understand the clinical
spectrum and associated complications. 3) To analyze the demographic prole of ST cases.
MATERIAL & METHODS: The retrospective study was carried out, over a period of 24 months (August 2015 to July 2017), which included
cases of AFI, clinically suspected of ST. Serological testing was carried out by using commercial ELISA for specic IgM antibodies against
O.tsutsugamushi.
RESULTS: Out of the total 3854 cases of AFI attending the tertiary care hospital, the microbiology laboratory received a total of 760 clinically
suspected cases of ST for serological testing, 494 cases (12.81%) were found positive for IgM antibodies against O.tsutsugamushi.The common
symptoms noted were fever with headache, myalgias, gastrointestinal intolerance, followed by breathlessness, rash and jaundice. Eschar was
seen only in 69 patients. The most common complication noticed was ARDS (8.29%) followed by hepatitis (6.88%), petechial heamorrhagic
spots (38.3%) and sepsis (6.07%). Mortality rate was found to be 1.8%. The cases were mainly seen in the months between August to October
which correlates the infection with the rainy season.
CONCLUSION: ST should be considered as one of the differential diagnosis of AFI. Timely diagnosis and management becomes crucial to
decrease/limit the diease burden, thus thwarting the onset of complications and mortality
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