CLINICAL PROFILE, EPIDEMIOLOGY AND PROGNOSTIC FACTORS IN SCRUB TYPHUS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 21
Abstract
BACKGROUND Scrub typhus is an underdiagnosed disease, but potentially treatable, if diagnosis is made with high index of suspicion. Deaths are attributable to late presentation, delayed diagnosis and drug resistance. MATERIALS AND METHODS The study was an observational study of prospective design conducted in the Department of General Medicine, Government Medical College, Kozhikode, over a period of one year. History, physical examination and relevant lab investigations were done in 70 patients in the study. RESULTS Majority of patients were in working class. Most common physical finding was lymphadenopathy. Eschar was present in 46% of patients. Majority responded to doxycycline. Case fatality was 14.3%. CONCLUSION 1. Most cases occurred during cooler months of the year (Oct-Feb). 2. Fever and headache were the most common symptoms. 3. Lymphadenopathy was the most common sign followed by splenomegaly. 4. Eschar was present in 46% cases. 5. Leucocytosis was associated with poor prognosis and increased complication like meningoencephalitis. 6. Hypoalbuminaemia was associated with increased incidence of complications like myocarditis and encephalitis. 7. More than 2 times, elevation of transaminases was a poor prognostic marker. 8. Most common and important complication was Acute Kidney Injury (AKI). 9. Microangiopathic haemolysis could possibly be a contributory factor for high incidence of AKI associated with scrub typhus. 10. Rampant NSAID use is another contributory factor for high incidence of AKI associated with scrub typhus. 11. Resistance to doxycycline is emerging in our community and we should consider this possibility in cases with strong suspicion with no response to doxycycline.
Authors and Affiliations
Priyadarshini B, Jayesh Kumar P, Anitha P. M
Keywords
Related Articles
- EP ID EP215216
- DOI 10.18410/jebmh/2017/241
- Views 104
- Downloads 0
AN OBSERVATIONAL CLINICAL STUDY OF ASSESSING THE UTILITY OF PSS (POISON SEVERITY SCORE) AND GCS (GLASGOW COMA SCALE) SCORING SYSTEMS IN PREDICTING SEVERITY AND CLINICAL OUTCOMES IN OP POISONING
BACKGROUND Organophosphorus compound poisoning is the most common poisonings in India because of easy availability often requiring ICU care and ventilator support. Clinical research has indicated that respiratory failure...
CORACOCLAVICULAR LIGAMENT RECONSTRUCTION USING A SEMITENDINOSUS TENDON GRAFT WITH POLYESTER SUTURE NO. 5 (ETHIBOND) FOR TYPE-III ACROMIOCLAVICULAR DISLOCATION
BACKGROUND The aim of the study is to review the functional and radiological results of patients after coracoclavicular ligament reconstruction using a semitendinosus tendon graft for type-III acromioclavicular dislocati...
IDIOPATHIC PYODERMA GANGRENOSUM: REPORT IN A THREE YEAR OLD CHILD
Pyoderma gangrenosum is a rare, non-infectious and destructive skin disease. Its exact etiopathogenesis is not clearly understood and is believed to be due to immune dysfunction. Several theories have been postulated; ho...
CERVICAL PROLAPSE DURING THIRD TRIMESTER: A RARE ENTITY
Uterine prolapse is a common gynaecologic condition but is extremely rare during pregnancy. We present a 26-year old woman with g2p1l1, who came with pelvic organ prolapse for the first time during the third trimester, f...
NEW MINIMALLY-INVASIVE METHOD OF TREATING INTRAMEDULLARY CHRONIC OSTEOMYELITIS OF LONG BONES- A PRELIMINARY REPORT
BACKGROUND The classical method of treatment of chronic osteomyelitis with sequestrum needs saucerization and sequestrectomy which become quite difficult when small sequesrtrae are spread over a long span in medullary ca...