Clinical And Laboratory Profiles Of Scrub Typhus: A Multicenter Prospective Observational Study
Abstract
Scrub typhus, a neglected tropical disease caused by Orientia tsutsugamushi, has re-emerged as a significant cause of acute febrile illness in many parts of Asia, including India. Despite its prevalence, the clinical and laboratory features often overlap with other febrile illnesses such as malaria, dengue, and leptospirosis, making early diagnosis challenging. This prospective multicenter study aimed to evaluate the clinical presentation, laboratory findings, complications, and treatment outcomes in patients with scrub typhus across various healthcare centers in endemic regions of India.
A total of 280 patients diagnosed with scrub typhus were enrolled from three tertiary care centers over a period of 18 months. The most common clinical features were fever, headache, and myalgia. An eschar, a pathognomonic sign, was observed in 52% of patients. Laboratory findings showed a high prevalence of thrombocytopenia (65%) and elevated liver enzymes (73%). Complications such as acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), myocarditis, and multiorgan dysfunction syndrome (MODS) were noted in 21% of cases. The overall mortality rate was 4.3%. The majority of patients (78%) responded well to doxycycline therapy, with clinical improvement observed within 48 to 72 hours.
This study underscores the importance of early diagnosis and treatment in scrub typhus to prevent severe complications. Further efforts are needed to raise awareness of this disease in endemic regions and improve diagnostic capabilities at the primary healthcare level.
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