Changing Trends in the Clinical Suspicion of Scrub Typhus in Acute Febrile Illness Patients

Abstract

Introduction: Scrub typhus is an important and widespread cause of acute febrile illness (AFI), which can be diagnosed easily by serological assay. Methods: All cases of AFI were sent for Scrub Typhus serology by rapid Enzyme Linked Immuno-Sorbent Assay (ELISA) method. Anyone found positive was admitted for further evaluation. Results: In this series 80 % had liver abnormality, 80 % had ARDS, 40 % had renal failure, 40 % had eschar and 80 % of them had MODS. Only 20 % had clinical features of encephalitis with MRI brain haemorrhagic transformation of infarct. All patients responded well to treatment with Doxycycline with hospitalization of around 7-10 days. Conclusion: This case series highlights the importance of keeping a high index of clinical suspicion to exclude scrub typhus in all AFI patients.

Keywords

• acute febrile illness
• acute respiratory distress syndrome
• hepatorenal syndrome
• multiorgan dysfunction syndrome
• scrub typhus