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Scrub typhus: Clinical spectrum and outcome

BACKGROUND: Scrub typhus is one of the differential diagnoses for fever with thrombocytopenia. ARDS associated with Scrub typhus has high morbidity and mortality. AIMS: To evaluate clinical features, lab values, and outcome in patients with scrub typhus and comparison in patients with or without ARD...

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Autores principales: Venkategowda, Pradeep M., Rao, S. Manimala, Mutkule, Dnyaneshwar P., Rao, Mallela V., Taggu, Alai N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397627/
https://www.ncbi.nlm.nih.gov/pubmed/25878428
http://dx.doi.org/10.4103/0972-5229.154553
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author Venkategowda, Pradeep M.
Rao, S. Manimala
Mutkule, Dnyaneshwar P.
Rao, Mallela V.
Taggu, Alai N.
author_facet Venkategowda, Pradeep M.
Rao, S. Manimala
Mutkule, Dnyaneshwar P.
Rao, Mallela V.
Taggu, Alai N.
author_sort Venkategowda, Pradeep M.
collection PubMed
description BACKGROUND: Scrub typhus is one of the differential diagnoses for fever with thrombocytopenia. ARDS associated with Scrub typhus has high morbidity and mortality. AIMS: To evaluate clinical features, lab values, and outcome in patients with scrub typhus and comparison in patients with or without ARDS. METHODS: A prospective observational study was conducted on 109 patients with febrile illness and thrombocytopenia during a period of 12 months. All 109 patients were tested with both Immune-chromatography test and Weil felix test. Patients having either Immune-chromatography test/Weil felix test positive have been included and considered as scrub typhus positive whereas negative for both Immune-chromatography and Weil felix test were excluded. Clinical features, lab parameters, and outcome were evaluated in all patients with scrub typhus. Statistical analysis used in this study was T-test. RESULTS: Among 58 patients who were included (After exclusion of 51 patients among total of 109 patients) 34 patients had no ARDS and 24 patients had ARDS. The clinical feature like dyspnoea, cough, low blood pressure (MAP<65 mmHg), IVC collapsibility (by ultrasound) and laboratory parameters like decreased Hemoglobin, Hematocrit, Serum albumin, and increased serum creatinine, serum total bilirubin, SGOT, SGPT, LDH, CPK, and serum lactate were statistically significant (P < 0.0001) in scrub typhus patients group with ARDS. The higher titers of Weil-felix can be correlated with more severe form of disease according to our observation. All 34 Scrub typhus patients without ARDS recovered completely. Among 24 Scrub typhus patients with ARDS, 22 patients recovered, and 2 patients died. CONCLUSION: Scrub typhus is an important differential diagnosis in a patients having fever with thrombocytopenia. Scrub typhus associated with ARDS has high morbidity and mortality. Early diagnosis and treatment with doxycycline can prevent the occurrence of ARDS
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spelling pubmed-43976272015-04-15 Scrub typhus: Clinical spectrum and outcome Venkategowda, Pradeep M. Rao, S. Manimala Mutkule, Dnyaneshwar P. Rao, Mallela V. Taggu, Alai N. Indian J Crit Care Med Research Article BACKGROUND: Scrub typhus is one of the differential diagnoses for fever with thrombocytopenia. ARDS associated with Scrub typhus has high morbidity and mortality. AIMS: To evaluate clinical features, lab values, and outcome in patients with scrub typhus and comparison in patients with or without ARDS. METHODS: A prospective observational study was conducted on 109 patients with febrile illness and thrombocytopenia during a period of 12 months. All 109 patients were tested with both Immune-chromatography test and Weil felix test. Patients having either Immune-chromatography test/Weil felix test positive have been included and considered as scrub typhus positive whereas negative for both Immune-chromatography and Weil felix test were excluded. Clinical features, lab parameters, and outcome were evaluated in all patients with scrub typhus. Statistical analysis used in this study was T-test. RESULTS: Among 58 patients who were included (After exclusion of 51 patients among total of 109 patients) 34 patients had no ARDS and 24 patients had ARDS. The clinical feature like dyspnoea, cough, low blood pressure (MAP<65 mmHg), IVC collapsibility (by ultrasound) and laboratory parameters like decreased Hemoglobin, Hematocrit, Serum albumin, and increased serum creatinine, serum total bilirubin, SGOT, SGPT, LDH, CPK, and serum lactate were statistically significant (P < 0.0001) in scrub typhus patients group with ARDS. The higher titers of Weil-felix can be correlated with more severe form of disease according to our observation. All 34 Scrub typhus patients without ARDS recovered completely. Among 24 Scrub typhus patients with ARDS, 22 patients recovered, and 2 patients died. CONCLUSION: Scrub typhus is an important differential diagnosis in a patients having fever with thrombocytopenia. Scrub typhus associated with ARDS has high morbidity and mortality. Early diagnosis and treatment with doxycycline can prevent the occurrence of ARDS Medknow Publications & Media Pvt Ltd 2015-04 /pmc/articles/PMC4397627/ /pubmed/25878428 http://dx.doi.org/10.4103/0972-5229.154553 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Venkategowda, Pradeep M.
Rao, S. Manimala
Mutkule, Dnyaneshwar P.
Rao, Mallela V.
Taggu, Alai N.
Scrub typhus: Clinical spectrum and outcome
title Scrub typhus: Clinical spectrum and outcome
title_full Scrub typhus: Clinical spectrum and outcome
title_fullStr Scrub typhus: Clinical spectrum and outcome
title_full_unstemmed Scrub typhus: Clinical spectrum and outcome
title_short Scrub typhus: Clinical spectrum and outcome
title_sort scrub typhus: clinical spectrum and outcome
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397627/
https://www.ncbi.nlm.nih.gov/pubmed/25878428
http://dx.doi.org/10.4103/0972-5229.154553
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