Scrub typhus in Southern India: are we doing enough?

Razak, Abdul; Sathyanarayanan, Vishwanath; Prabhu, Mukhyaprana; Sangar, Madhusudan; Balasubramanian, R

doi:10.1258/td.2010.090508

Cited by 29 publications

(29 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Outbreaks are reported during the cooler months of the year in parts of South India like Tamil Nadu and Pondicherry, particularly during the post monsoon period of November through March. Cooler climate in areas, which provide optimum condition for the mites to survive, forecasts the outbreak of scrub typhus [10,11].…”

Section: Discussionmentioning

confidence: 99%

Clinico - Laboratory Profile of Scrub Typhus — An Emerging Rickettsiosis in India

et al. 2016

View full text Add to dashboard Cite

Regional lymphadenopathy is a marker of hidden or developing eschar. Total count and differential count should be interpreted on the background of the duration of fever. Since IgM ELISA, which is diagnostic of scrub typhus may not be widely available, any febrile child coming from rural area with hepatosplenomegaly, pallor, eschar, generalised / regional lymphadenopathy, anemia, leucocytosis, thrombocytopenia and increased Aspartate transaminase (AST) /Alanine aminotransferase (ALT) should be started on empirical Doxycycline or Azithromycin in order to prevent life threatening complications secondary to delay in therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinico - Laboratory Profile of Scrub Typhus — An Emerging Rickettsiosis in India

et al. 2016

View full text Add to dashboard Cite

show abstract

“…People with scrub typhus develop a high fever, maculopapular rash, skin eschars, lymphadenopathy, headache, and myalgia (3). The diagnosis of scrub typhus is based on the patient's exposure history, the clinical features, and the results of serologic testing (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of scrub typhus is based on the patient's exposure history, the clinical features, and the results of serologic testing (4,5). It occurs in persons who engage in occupational or recreational behavior that brings them into contact with mite-infested habitats such as brush and grass (3,(6)(7)(8)(9)(10). In such environments, trombiculid mite larvae can be found in any location that is suitable for rodent populations and has ground moisture sufficient to nourish the mite vectors (11).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of Drug Treatment for Scrub Typhus in Asia

Fang

Huang²,

Tu³

et al. 2012

Intern. Med.

View full text Add to dashboard Cite

Objective Scrub typhus is an important febrile disease in Asia, and antibiotics have been used to treat this disease. The purpose of this study was to generate large-scale evidence of the efficacy of different antibiotic regimens for treating scrub typhus using a meta-analysis. Methods PubMed, Elsevier ScienceDirect, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. The data from eligible citations were extracted by two reviewers. All analyses were performed using the Cochrane Collaboration Review Manager 4.2 and Stata 10.0 software programs. Results We conducted a meta-analysis of 17 separate studies that evaluated the efficacy of treatment with the different antibiotic regimens for scrub typhus. The median time (h) to clearance of fever in the azithromycin-treated group was longer than that in the chloramphenicol-treated group (weighted mean difference [WMD] = 12.66, 95% confidence interval [CI]: 2.26,23.06). Adverse events were 2.95 (95%CI: 1.32, 6.61) times more likely to occur in the azithromycin-treated group than in the chloramphenicol-treated group. The clearance time (days) for the main symptoms (including fever, headache, rash and lymphadenectasis) in the doxycycline-treated group was shorter than that in the chloramphenicol-treated group (WMD = -0.4, 95%CI: -0.53, -0.26) in five trials. Adverse drug events occurred significantly less frequently in the azithromycin-treated group than in the doxycycline-treated group (relative risk [RR] = 0.47, 95%CI: 0.31,0.71). Conclusion Doxycycline was found to act more quickly, but more adverse drug events occur when using this regimen compared to azithromycin and chloramphenicol.

show abstract

“…6 In last few years there have been outbreaks of scrub typhus in states of south India especially Karnataka. 5 Scrub typhus is transmitted to humans by the bite of larval trombiculid mites. These larval mites usually feed on the wild rats.…”

Section: Discussionmentioning

confidence: 99%

“…8 The occurrence of eschar is less frequent among South-East Asian patients. 5 It has been reported that in dark-skinned patients early eschar could be easily overlooked and the eschar may be very small. 9 It is important to carefully examine the front chest, areas where the skin is folded and areas within 30 cm below the umbilicus in both sexes, lower limbs of males and the front chest and back in females for Eschars.…”

Section: Discussionmentioning

confidence: 99%

Scrub typhus, a reemerging zoonosis – An Indian case series

et al. 2014

View full text Add to dashboard Cite

Background:Rickettsial diseases are reemerging in many parts of our country. Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi. It is difficult to diagnose Scrub typhus because of nonspecific clinical presentation and lack of availability of specific tests (ELISA) in all centres. Aim: Our aim was to study the clinical features, lab parameters and outcome of patients diagnosed with Scrub typhus. Materials and Methods: A retrospective hospital based study was done in Mangalore (Karnataka) to identify cases of scrub typhus. Patients who had an acute febrile illness and IgM antibodies against O. tsutsugamushi were included in our study. Results: 10 cases of Scrub typhus were identified. Among them 7(70%) patients were females and 3(30%) were males. Major symptoms on admission were fever10(100%), dyspnea or cough-2(20%), rashes1(10%), altered sensorium1(10%). The major signs were fever10(100%), eschar 2(20%), and signs of meningial irritation in 1(10%). Lab parameters showed leukocytosis in 4(40%), thrombocytopenia in 3(30%), raised liver enzymes in 3(30%) and renal failure in 3(30%). Chest X-ray showed consolidation in 2(20%) patients. There was no mortality in our study. Conclusion: Scrub typhus can present with varying clinical manifestations and eschar can be absent in majority of cases as shown in our study. Therefore diagnosis should be based on a high index of suspicion and empirical treatment with doxycycline must be started whenever there is a strong suspicion of Scrub typhus.

show abstract

Scrub typhus in Southern India: are we doing enough?

Cited by 29 publications

References 14 publications

Clinico - Laboratory Profile of Scrub Typhus — An Emerging Rickettsiosis in India

Clinico - Laboratory Profile of Scrub Typhus — An Emerging Rickettsiosis in India

Meta-analysis of Drug Treatment for Scrub Typhus in Asia

Scrub typhus, a reemerging zoonosis – An Indian case series

Contact Info

Product

Resources

About