Clinicohematological, treatment, and outcome profile for scrub typhus: Observations from a tertiary care center

Abstract

BACKGROUND: Scrub typhus, an acute febrile illness, is one of the emerging and re-emerging infectious diseases in India. This study was undertaken to assess the clinicohematological, treatment, and outcome profile of the patients diagnosed with scrub typhus at the clinical microbiology department of a tertiary care teaching hospital in Coastal Karnataka, India. MATERIALS AND METHODS: This was a retrospective study conducted with patients diagnosed as scrub typhus between January 2014 and December 2017. The demographic, clinical, laboratory, treatment, and outcome profile of these patients were noted and analyzed by Student's t-test. A P < 0.5 was considered statistically significant. RESULTS: A total of 146 patients were included in the study. The males were more infected than females, and people in the age group of 51-60 years were affected the most. Fever (139, 95.2%) was the most common symptom. Eschar was seen in only 52 (34.89%) patients. Anemia, leukocytosis, neutrophilia, lymphocytopenia, eosinophilia, monocytosis, thrombocytopenia, and raised erythrocyte sedimentation rate were statistically significant in scrub patients. The hepatic and renal indicators were also deranged. All patients were treated with doxycycline, and platelet was transfused in 7 (4.8%) patients. Among the seven dead patients, there were significant eosinopenia and deranged renal parameters compared to the survived patients. CONCLUSION: In endemic area, when a middle-aged individual presents with fever and leukocytosis with thrombocytopenia with or without eschar, scrub typhus should be considered as a differential diagnosis and empirical therapy started.