Clinical Profile of Scrub Typhus and the Influence of Illness Duration and Antibiotic Timing on Outcomes

Abstract

Objectives: To study the clinical profile and factors affecting the duration of hospital stay in scrub typhus patients. Materials and Methods: This retrospective study was conducted at a tertiary care hospital situated close to the forest and foothill areas of Tamil Nadu. Patients aged 18 years and above, and diagnosed with scrub typhus were included in the study. Demographics, comorbidities, clinical features of patients, duration of illness, time of antibiotic initiation, and biochemical parameters were recorded for analysis. Mann-Whitney U test and chi-square tests were used to assess the association between various parameters. P-value<0.05 was considered statistically significant. Results: Among 143 scrub typhus patients’ records included, 65% (n=93) were from rural areas. All the patients survived and were discharged from the hospital. Fever (98.6%, n=141) and breathlessness (38.5%, n=55) were the most common presentations, along with thrombocytopenia (65.7%, n=94) and pneumonia (30.8%, n=44). Eighty-seven patients were hospitalized for <5 days. The initiation of antibiotics within 24 hours of admission was significantly associated with the duration of illness (Χ2=4.571, p=0.033), but not with the duration of hospitalization (Χ2=1.017, p=0.313). Breathlessness (p=0.000), loose stools (p=0.035), comorbid hypertension (p=0.021), and pneumonia (p=0.000) significantly influenced the length of hospitalization. Conclusion: In this study, the time of antibiotic initiation did not influence the clinical outcome in terms of the duration of hospitalization, however, comorbid hypertension and pneumonia did affect the duration of hospitalization significantly. More prospective studies need to be conducted for a generalizable result.

Keywords

• antibiotics
• hospitalization
• patient outcome
• scrub typhus
• retrospective