Indian Journal of Microbiology Research


Clinical and laboratory manifestations of scrub typhus: A study from a tertiary care hospital in Manipur


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Author Details: Smeeta Huidrom, L. Kokindro Singh

Volume : 4

Issue : 4

Online ISSN : 2394-5478

Print ISSN : 2394-546X

Article First Page : 434

Article End Page : 436


Abstract

Introduction: Orientia tsutsugamushi, are obligate intracellular Gram-negative coccobacilli belonging to the rickettsial family. Transmitted by the bite of infected mites, they cause Scrub typhus - a zoonotic febrile illness, which if not diagnosed is associated with a fatal outcome. It is often under-diagnosed in India and has been attributed to its non-specific clinical presentation, relative lack of awareness of the disease among clinicians and the lack of diagnostic facilities. As in other parts of India, seasonal outbreaks have been reported since 2006 in Manipur too.
Materials and Method: Patients presenting with febrile illness and diagnosed as scrub typhus over a period of 18 months (January 2016 to May 2017) were studied to study their clinical features and laboratory investigations. A single step solid phase immunochromatographic assay which detects IgM, IgG and IgA antibodies against O. tsutsugamushi was used to make the diagnosis. All relevant data of the patients were retrieved from the case files.
Results: 24 (23.7%) patients of the 118 clinically suspected patients tested positive for Scrub typhus by serology. Fever, headache and myalgia were the most common symptoms followed by diarrhoea and vomiting. Elevated liver enzymes and serum bilirubin was observed in most of the patients. Eschar was seen in 6 (5%) cases. The cases were however observed to be not confined to the district of Bishenpur, from where previous seasonal outbreaks had been reported. All the patients responded quickly to Doxycycline.
Conclusion: Scrub typhus is being seen with regularity in the recent past and has often been described as a re-emerging rickettsial infection. Increased awareness coupled with high index of suspicion amongst treating doctors with good knowledge of epidemiology and laboratory investigations is needed for an early diagnosis. Cases can be diagnosed using a one step immune-chromatographic assay, a relatively sensitive method and specific test.

Keywords:
Pyrexia, Rickettsia, Eschar, Immune-chromatographic, Doxycycline

Doi No:-10.18231