Cargando…

Scrub Typhus and Other Rickettsial Infections

Scrub typhus and other rickettsial infections contribute to 25 – 50% of acute undifferentiated febrile illnesses in endemic regions. Delayed recognition and therapy increase the morbidity and mortality. The constellation of fever with eschar or rash and multisystem involvement should facilitate the...

Descripción completa

Detalles Bibliográficos
Autores principales: Gunasekaran, Karthik, Bal, Deepti, Varghese, George M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327791/
https://www.ncbi.nlm.nih.gov/pubmed/34345128
http://dx.doi.org/10.5005/jp-journals-10071-23841
_version_ 1783732168144453632
author Gunasekaran, Karthik
Bal, Deepti
Varghese, George M
author_facet Gunasekaran, Karthik
Bal, Deepti
Varghese, George M
author_sort Gunasekaran, Karthik
collection PubMed
description Scrub typhus and other rickettsial infections contribute to 25 – 50% of acute undifferentiated febrile illnesses in endemic regions. Delayed recognition and therapy increase the morbidity and mortality. The constellation of fever with eschar or rash and multisystem involvement should facilitate the diagnosis and initiation of appropriate therapy. The pathological hallmark of rickettsial infections is endothelial infection and inflammation causing vasculitis. Endothelial inflammation results in microvascular dysfunction and increased vascular permeability. Immune and endothelial activation may worsen microvascular dysfunction, predisposing to multi-organ failure. Serology is the mainstay of diagnosis, although false negatives occur early in the disease. Point-of-care rapid diagnostic tests and molecular techniques, such as quantitative polymerase chain reaction (qPCR), can hasten diagnostic processes. Intravenous doxycycline with a loading dose is the most widely used antibiotic in critically ill patients, with azithromycin as a suitable alternative. Early appropriate treatment and organ support can decrease the duration of illness and be life-saving. How to cite this article: Gunasekaran K, Bal D, Varghese GM, et al. Scrub Typhus and Other Rickettsial Infections. Indian J Crit Care Med 2021;25(Suppl 2):S138–S143.
format Online
Article
Text
id pubmed-8327791
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Jaypee Brothers Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-83277912021-08-02 Scrub Typhus and Other Rickettsial Infections Gunasekaran, Karthik Bal, Deepti Varghese, George M Indian J Crit Care Med Invited Article Scrub typhus and other rickettsial infections contribute to 25 – 50% of acute undifferentiated febrile illnesses in endemic regions. Delayed recognition and therapy increase the morbidity and mortality. The constellation of fever with eschar or rash and multisystem involvement should facilitate the diagnosis and initiation of appropriate therapy. The pathological hallmark of rickettsial infections is endothelial infection and inflammation causing vasculitis. Endothelial inflammation results in microvascular dysfunction and increased vascular permeability. Immune and endothelial activation may worsen microvascular dysfunction, predisposing to multi-organ failure. Serology is the mainstay of diagnosis, although false negatives occur early in the disease. Point-of-care rapid diagnostic tests and molecular techniques, such as quantitative polymerase chain reaction (qPCR), can hasten diagnostic processes. Intravenous doxycycline with a loading dose is the most widely used antibiotic in critically ill patients, with azithromycin as a suitable alternative. Early appropriate treatment and organ support can decrease the duration of illness and be life-saving. How to cite this article: Gunasekaran K, Bal D, Varghese GM, et al. Scrub Typhus and Other Rickettsial Infections. Indian J Crit Care Med 2021;25(Suppl 2):S138–S143. Jaypee Brothers Medical Publishers 2021-05 /pmc/articles/PMC8327791/ /pubmed/34345128 http://dx.doi.org/10.5005/jp-journals-10071-23841 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Invited Article
Gunasekaran, Karthik
Bal, Deepti
Varghese, George M
Scrub Typhus and Other Rickettsial Infections
title Scrub Typhus and Other Rickettsial Infections
title_full Scrub Typhus and Other Rickettsial Infections
title_fullStr Scrub Typhus and Other Rickettsial Infections
title_full_unstemmed Scrub Typhus and Other Rickettsial Infections
title_short Scrub Typhus and Other Rickettsial Infections
title_sort scrub typhus and other rickettsial infections
topic Invited Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327791/
https://www.ncbi.nlm.nih.gov/pubmed/34345128
http://dx.doi.org/10.5005/jp-journals-10071-23841
work_keys_str_mv AT gunasekarankarthik scrubtyphusandotherrickettsialinfections
AT baldeepti scrubtyphusandotherrickettsialinfections
AT varghesegeorgem scrubtyphusandotherrickettsialinfections