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Prevalence of scrub typhus in a tertiary care centre in Telangana, south India

BACKGROUND AND OBJECTIVES: Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the “gold standard” immunofluorescent assay and the unreliable nature of Weil Felix test often results in delayed or m...

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Autores principales: Lakshmi, Ram Mohan Mylavarapu Venkata Naga, Dharma, Teja Vijay, Sudhaharan, Sukanya, Surya, Subbalaxmi Malladi Venkata, Emmadi, Rajkiran, Yadati, Satyanarayana Raju, Modugu, Nageswara Rao, Jyotsna, Aparna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340608/
https://www.ncbi.nlm.nih.gov/pubmed/32685116
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author Lakshmi, Ram Mohan Mylavarapu Venkata Naga
Dharma, Teja Vijay
Sudhaharan, Sukanya
Surya, Subbalaxmi Malladi Venkata
Emmadi, Rajkiran
Yadati, Satyanarayana Raju
Modugu, Nageswara Rao
Jyotsna, Aparna
author_facet Lakshmi, Ram Mohan Mylavarapu Venkata Naga
Dharma, Teja Vijay
Sudhaharan, Sukanya
Surya, Subbalaxmi Malladi Venkata
Emmadi, Rajkiran
Yadati, Satyanarayana Raju
Modugu, Nageswara Rao
Jyotsna, Aparna
author_sort Lakshmi, Ram Mohan Mylavarapu Venkata Naga
collection PubMed
description BACKGROUND AND OBJECTIVES: Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the “gold standard” immunofluorescent assay and the unreliable nature of Weil Felix test often results in delayed or misdiagnosis in a majority of cases. The present study seeks to integrate the results of rapid diagnostic tests, clinical and laboratory features to aid the diagnosis and management of scrub typhus patients. MATERIALS AND METHODS: A total of 645 serum samples with suspected scrub typhus sent to the Department of Microbiology were included in the study. Scrub typhus was tested by rapid immunochromatographic test (SD Diagnostics) and IgM ELISA (Inbios International, USA). Clinical features, laboratory parameters and final outcome were analysed from the clinical records of positive patients. RESULTS: Scrub typhus was diagnosed in 13.7% of patients and majority of them were observed in the month of August. 58.6% of scrub typhus patients presented with fever of one to two weeks duration. Eschar was documented in 13.7% of patients and 24% of patients gave a history of working outdoors or exposure to vegetation. All the patients responded to Doxycycline treatment and there was no mortality. CONCLUSION: High index of suspicion for scrub typhus is necessary in febrile patients not responding to conventional antibiotics especially during outbreak situations. Rapid immunochromatographic tests with excellent specificity and acceptable sensitivity can be used as potential point of care tests for quick diagnosis of scrub typhus especially in delayed presentation.
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spelling pubmed-73406082020-07-17 Prevalence of scrub typhus in a tertiary care centre in Telangana, south India Lakshmi, Ram Mohan Mylavarapu Venkata Naga Dharma, Teja Vijay Sudhaharan, Sukanya Surya, Subbalaxmi Malladi Venkata Emmadi, Rajkiran Yadati, Satyanarayana Raju Modugu, Nageswara Rao Jyotsna, Aparna Iran J Microbiol Original Article BACKGROUND AND OBJECTIVES: Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the “gold standard” immunofluorescent assay and the unreliable nature of Weil Felix test often results in delayed or misdiagnosis in a majority of cases. The present study seeks to integrate the results of rapid diagnostic tests, clinical and laboratory features to aid the diagnosis and management of scrub typhus patients. MATERIALS AND METHODS: A total of 645 serum samples with suspected scrub typhus sent to the Department of Microbiology were included in the study. Scrub typhus was tested by rapid immunochromatographic test (SD Diagnostics) and IgM ELISA (Inbios International, USA). Clinical features, laboratory parameters and final outcome were analysed from the clinical records of positive patients. RESULTS: Scrub typhus was diagnosed in 13.7% of patients and majority of them were observed in the month of August. 58.6% of scrub typhus patients presented with fever of one to two weeks duration. Eschar was documented in 13.7% of patients and 24% of patients gave a history of working outdoors or exposure to vegetation. All the patients responded to Doxycycline treatment and there was no mortality. CONCLUSION: High index of suspicion for scrub typhus is necessary in febrile patients not responding to conventional antibiotics especially during outbreak situations. Rapid immunochromatographic tests with excellent specificity and acceptable sensitivity can be used as potential point of care tests for quick diagnosis of scrub typhus especially in delayed presentation. Tehran University of Medical Sciences 2020-06 /pmc/articles/PMC7340608/ /pubmed/32685116 Text en Copyright© 2020 Iranian Neuroscience Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lakshmi, Ram Mohan Mylavarapu Venkata Naga
Dharma, Teja Vijay
Sudhaharan, Sukanya
Surya, Subbalaxmi Malladi Venkata
Emmadi, Rajkiran
Yadati, Satyanarayana Raju
Modugu, Nageswara Rao
Jyotsna, Aparna
Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title_full Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title_fullStr Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title_full_unstemmed Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title_short Prevalence of scrub typhus in a tertiary care centre in Telangana, south India
title_sort prevalence of scrub typhus in a tertiary care centre in telangana, south india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340608/
https://www.ncbi.nlm.nih.gov/pubmed/32685116
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