A study of complications of scrub typhus in a tertiary health care institute of Uttarakhand, India

Abstract

Background : Scrub typhus or tsutsugamushi disease is a febrile illness caused by Orientia tsutsugamushi. Uttarakhand State in the northern region of India has been witnessing increased incidence of this fever. There is paucity of data on this topic from this region. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from scrub typhus in a tertiary health care institute of Uttarakhand, India. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary health care institute Uttrakhand. The study period was of 1year from December 2012 to November 2013. Patients of 12 years of age or above it who were IgM antibody positive by ELISA technique were included in the study. All such patients underwent detailed clinical examination and investigation. Results: 47 patients were found to be suffering from scrub typhus. The common symptoms noted fever, myalgias, headache, vomiting, diarrhoea, breathlessness, petechiae and jaundice. Common complications noticed were hepatitis (78.7%) acute respiratory distress syndrome (19.2%), thrombocytopenia (46.8%) and acute renal failure (31.9%), Mortality was seen in 3 (6.4%) patients. Conclusions: Scrub typhus is an important cause of mortality and morbidity in Uttarakhand. High index of suspicion, early diagnosis, monitoring of the clinical and laboratory parameters and prompt intervention may help in reducing the mortality.