Abstract
Scrub typhus is endemic in India. Right now scrub typhus is enjoying its status as a re-emerging disease and is often causing trouble in diagnosis due to absence of specific rash or eschar. In our institution, we observed a seasonal rise of febrile illnesses that coincided with monsoon rain, and decided to investigate the probable etiological role of scrub typhus among the undiagnosed fever cases. This prospective study was conducted from the middle of May to the end of August in 2019. All febrile patients who tested negative for malaria, dengue, urinary tract infections, enteric fever and other pyogenic infections were included in this study. Those who became serologically reactive for Scrub typhus IgM antibody by ELISA were considered as established cases of scrub typhus. The seroprevalence of scrub typhus among undiagnosed fever cases was 33.9% with a resultant mortality of 11.8%. Fever (100%), headache (92%) and myalgia (62%) were the commonest symptoms followed by lymphadenopathy, vomiting, diarrhea, pain abdomen, rash and rarely eschar. Meningoencephalitis (12%) was the commonest complication followed by acute kidney injury which along with hepatitis often led to fatal multi organ failure. Thus, scrub typhus should be considered at the earliest in the differential diagnoses for acute undiagnosed fever with nonspecific features in endemic countries like ours.
Keywords: Scrub typhus, IgM ELISA, undiagnosed fever, non-specific features, meningoencephalitis.
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Corresponding Author
Dr Purba Mukherjee
Assistant Professor, Department of Microbiology, Calcutta National Medical College, Kolkata
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.63
