Mortality due to scrub typhus – report of five cases

Chaudhry, Rama; Thakur, Chandan Kumar; Gupta, Nitin; Sagar, Tanu; Bahadur, Tej; Wig, Naveet; Sood, Rita; Misra, Mahesh Chandra

doi:10.4103/ijmr.ijmr_1314_18

Cited by 15 publications

(23 citation statements)

References 13 publications

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“…24,25 Five fatal cases described that all had elevated transaminase levels (AST > ALT), with multiorgan failure as the cause of death. 26…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Five fatal cases described that all had elevated transaminase levels (AST > ALT), with multiorgan failure as the cause of death. 26 Doxycycline, at a dose of 100 mg bd for 10-14 days, remains the first line treatment. Other antibiotics which may be used include tetracycline, azithromycin and rifampicin, the last of which is normally reserved for anti-tubercular treatment.…”

Section: Discussionmentioning

confidence: 99%

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Scrub typhus-related hepatotoxicity: The Indian scenario

2021

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In Scrunb Typhus, hepatotoxicity is an important, yet understudied, manifestation. We reviewed studies on scrub typhus, published in the last five years (2014–2019), which evaluated its clinico-epidemiological factors in India, and concentrated on its hepatic involvement. Nine studies were found, and no Indian study exclusively evaluated hepatic dysfunction. Thus, comments from a few international studies were also included. We conclude that liver dysfunction in the form of elevated serum transaminase levels is a common manifestation of scrub typhus, which may herald progress to fulminant hepatic failure.

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“…24,25 Five fatal cases described that all had elevated transaminase levels (AST > ALT), with multiorgan failure as the cause of death. 26…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Scrub typhus-related hepatotoxicity: The Indian scenario

2021

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“…Scrub typhus outbreaks occurred again in the period of 2002–2003 among the inhabitants of the Maldives, indicating the endemic nature of this disease [ 88 ]. This is certainly the case for India, where numerous publications have shown the breadth of scrub typhus throughout the subcontinent [ 89 , 90 , 91 , 92 , 93 ].…”

Section: Early History Of Scrub Typhus and The Etiologic Agents Ofmentioning

confidence: 99%

Scrub Typhus: Historic Perspective and Current Status of the Worldwide Presence of Orientia Species

Richards

Jiang

2020

TropicalMed

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Scrub typhus and its etiological agents, Orientia species, have been around for a very long time. Historical reference to the rickettsial disease scrub typhus was first described in China (313 AD) by Hong Ge in a clinical manual (Zhouhofang) and in Japan (1810 AD) when Hakuju Hashimoto described tsutsuga, a noxious harmful disease in the Niigata prefecture. Other clinicians and scientists in Indonesia, Philippines, Taiwan, Australia, Vietnam, Malaysia, and India reported on diseases most likely to have been scrub typhus in the early 1900s. All of these initial reports about scrub typhus were from an area later designated as the Tsutsugamushi Triangle—an area encompassing Pakistan to the northwest, Japan to the northeast and northern Australia to the south. It was not until the 21st century that endemic scrub typhus occurring outside of the Tsutsugamushi Triangle was considered acceptable. This report describes the early history of scrub typhus, its distribution in and outside the Tsutsugamushi Triangle, and current knowledge of the causative agents, Orientia species.

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“…Most patients recover after prompt and proper treatment. However, delayed diagnosis and treatment may lead to bacterium mediated-vascular injury in various vital organs, including the liver, kidneys, meninges and brain [ 9 ]; and disseminated intravascular coagulopathy (DIC) with platelet consumption, vascular leakage, pulmonary edema, shock and organ failure, which may eventually result in death [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

GroEL Chaperonin-Based Assay for Early Diagnosis of Scrub Typhus

et al. 2022

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A point-of-care diagnostic for early and rapid diagnosis of scrub typhus caused by Orientia tsutsugamushi is required for prompt and proper treatment of patients presenting with undifferentiated febrile illnesses. In this study, an immunochromatographic antigen detection test kit (ICT AgTK) that targets the highly conserved O. tsutsugamushi 60 kDa GroEL chaperonin (heat shock protein 60) was developed. E. coli-derived recombinant GroEL expressed from DNA coding for the consensus sequence of 32 GroEL gene sequences extracted from the GenBank database was used to immunize rabbits and mice. Rabbit polyclonal antibodies (pAb) were used for preparing a gold-pAb conjugate, and the rGroEL-specific mouse monoclonal antibody was used as the antigen detection reagent at the ICT test line. In-house validation revealed that the ICT AgTK gave 85, 100 and 95% diagnostic sensitivity, specificity and accuracy, respectively, compared to the combined clinical features and standard IFA when tested on 40 frozen serum samples. The test kits correctly identified 10 scrub typhus samples out of 15 fresh plasma/buffy coat samples of patients with febrile illnesses. For independent laboratory validation, the ICT AgTK was sent to one provincial hospital. The ICT AgTK utilized by the hospital medical technologist correctly identified six scrub typhus samples out of 20 serum samples of patients with fever, as confirmed by specific IgM/IgG detection by IFA. The ICT AgTK is easy to perform with rapid turn-around time. It has the potential to be used as an important tool for on-site and early scrub typhus diagnosis by allowing testing of freshly collected samples (serum, plasma or buffy coat), especially in resource-limited healthcare settings.

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Mortality due to scrub typhus – report of five cases

Cited by 15 publications

References 13 publications

Scrub typhus-related hepatotoxicity: The Indian scenario

Scrub typhus-related hepatotoxicity: The Indian scenario

Scrub Typhus: Historic Perspective and Current Status of the Worldwide Presence of Orientia Species

GroEL Chaperonin-Based Assay for Early Diagnosis of Scrub Typhus

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