Predictors of severity of scrub typhus in the Indian subcontinent

Karanth, Suman S; Marupudi, Krishna Chaitanya; Sama, Varun Pal Reddy; Gupta, Anurag; Ballal, Kirthinath; Kamath, Asha

doi:10.1016/s2222-1808(14)60705-2

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…There was no significance difference between the two groups with regard to eschar. In this regard, Karanth et al (14), reported eschar in 40.38% of patients in the non-severe group. Conversely, in the study by Narayanasamy et al (15), only 25% of patients with severe scrub typhus developed eschar.…”

Section: Discussionmentioning

confidence: 92%

“…On the other hand, two studies from India reported higher rates than our study. A study by Karanth et al (14), from Karnataka, India, demonstrated that 52.7% of patients had severe scrub typhus, while another study from Pondicherry reported a prevalence of 40.6%. In the study by Karanth et al (14), the number of patients with severe scrub typhus was higher in younger age groups, while the incidence of severe scrub typhus was lower in children above five years.…”

Section: Discussionmentioning

confidence: 97%

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Clinical Characteristics and Predictors of Severity of Pediatric Scrub Typhus in a Tertiary Level Hospital in South India

Elayaraja

Rajan

Pasupathy

et al. 2020

Arch Pediatr Infect Dis

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Background: Scrub typhus, a zoonosis caused by bacteria Orientia tsutsugamushi is associated with varying clinical features and significant mortality due to complication in view of ineffective treatment. Objectives: This study was undertaken to identify the factors for predicting severity in scrub typhus. Methods: This retrospective study was conducted at a tertiary care teaching hospital between January 2015 to October 2016. All children younger than 18 years of age admitted with a history of fever for more than seven days and positive IgM ELISA for scrub typhus were included in the study. Cases of "severe scrub typhus" were identified based on criteria from published pediatric studies. A total of 235 patients tested positive for scrub typhus, out of which 39 patients were in the severe scrub group and 196 in the nonsevere group. Reports were analyzed for the predictors of severity of scrub typhus in both groups. Results: Using multivariate analysis, the factors for predicting severity in scrub typhus were hemoglobin < 10 g/L (OR = 2.8, CI = 1.40 to 5.72), platelet < 150 000 cells/mm 3 (OR = 2.54, CI = 1.21 to 5.30), albumin < 2.5 g/d (OR = 3.18, CI = 1.42 to 7.11), SGOT > 5 fold rise (OR = 49.7, CI = 13.49 to 183.17), prolongation of PT (P value = 0.03), and altered sensorium (P value = 0.016) were correlated with severe disease. Conclusions: We conclude that altered sensorium, anemia, thrombocytopenia, elevated transaminases, hypoalbuminemia, and prolongation of prothrombin time to be predictors of severity of illness in scrub typhus.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Clinical Characteristics and Predictors of Severity of Pediatric Scrub Typhus in a Tertiary Level Hospital in South India

Elayaraja

Rajan

Pasupathy

et al. 2020

Arch Pediatr Infect Dis

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“…A study by Karanth et al (2014) concluded that low hemoglobin level (<12 gm/ dL), leukocytosis (>10,000 cells/mm 3 ), thrombocytopenia (<150,000 cells/mm 3 ), and absence of eschar were independent predictors of ST severity [26] . Differences in clinical features, organ involvement, and laboratory parameters in various studies are due to the genotypic diversity of O. Tsutsugamushi attributable to its 56 kDa protein antigen.…”

Section: Table 5) Association Of Organ Dysfunction With Hypotension I...mentioning

confidence: 99%

An Overview of the Clinical Profile and Risk Factors Associated with Severe Scrub Typhus Infection: A Hospital Based Study in Coimbatore

Jakir Hussain,

Kumar,

Boopathy

et al. 2023

IEM

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Backgrounds: Scrub typhus (ST) is an important cause of acute undifferentiated febrile illness. ST is caused by Orientia tsutsugamushi transmitted by the bite of a trombiculid mite. It is endemic in East Asia, the South Pacific, and the Indian subcontinent. In India, ST accounts for about 23% of all febrile illnesses. This study aimed to assess the clinical profile of ST and associated risk factors. Materials & Methods:This cross-sectional study was conducted on 47 participants in the general medicine department of a tertiary medical college hospital in Coimbatore, south India from January 2020 to June 2021. All the participants suffered from fever and diagnosed with ST based on seropositivity of IgM enzyme linked immunosorbent assay (ELISA). Complete blood count, renal and liver function tests, and chest X-ray were performed. All the participants were admitted to the hospital and followed up. Findings: The participants' age ranged from 18-80 years with a mean age of 48.40 years. Most ST cases occurred during January (48.9%). Fever was the common symptom (95.7%), while eschar was reported in only 19.1% of the individuals. Thrombocytopenia was detected in 12.8% of ST patients. Hypoalbuminemia was reported in 80% of those with hepatic dysfunction, and anemia was present in 28% of those with acute kidney injury. Conclusion: This disease could present as a severe illness even in non-ICU (intensive care units) settings, and a high degree of suspicion is necessary for diagnosing and treating ST patients in endemic areas.

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Under-diagnosis of rickettsial disease in clinical practice: A systematic review

Eekeren

Vries

Wagenaar

et al. 2018

Travel Medicine and Infectious Disease

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Predictors of severity of scrub typhus in the Indian subcontinent

Cited by 5 publications

References 18 publications

Clinical Characteristics and Predictors of Severity of Pediatric Scrub Typhus in a Tertiary Level Hospital in South India

Clinical Characteristics and Predictors of Severity of Pediatric Scrub Typhus in a Tertiary Level Hospital in South India

An Overview of the Clinical Profile and Risk Factors Associated with Severe Scrub Typhus Infection: A Hospital Based Study in Coimbatore

Under-diagnosis of rickettsial disease in clinical practice: A systematic review

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