Dr. Rishi Kumar Tailor, Dr. Madhuri Meena, Dr. Y. K. Sanadhya


Background : Scrub typhus or tsutsugamushi disease is a febrile illness caused by Orientia tsutsugamushi. Increased incidence of this fever had been reported in recent past. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from scrub typhus in a tertiary health care institute in south-east Rajasthan, India.

Methods: A hospital based prospective observational study of patients of acute febrile illness performed at tertiary health care institute in south-east Rajasthan. patients of acute febrile illness of more than 14 years of age, admitted in medicine department during November 2018 to October 2019, with IgM ELISA positive for Scrub Typhus were enrolled in the study as study participants. All such patients underwent detailed clinical examination and investigation.

Results : A total of 134 patients were diagnosed with scrub typhus, with females more than males  and most common age group was 31 to 40 years(29.9%). Most common presenting symptom was fever (100%) followed by Headache(80.59%) and Dry Cough(66.42%) while Rash was present in only 14.18%. ESCHAR which is pathognomic of scrub typhus was found in 46.27% patients. Most common complication was pneumonia (39.6%) followed by hepatitis (35.8%),MODS (29%), ARDS(23.1%), septic shock (17.2%), acute kidney injury(9%) and all of them were significantly associated with mortality(p<0.05). Mortality was observed in 6.7% of cases.

Conclusion : Scrub typhus is an important cause of acute febrile illness with multisystem involvement in south eastern belt of Rajasthan. A high index of suspicion is needed in patients presenting with fever especially during monsoon and post monsoon season. In resource limited settings and pending laboratory confirmation we should implement a ‘suspect and treat’ strategy and initiate prompt treatment with Doxycycline or Azithromycin, to prevent serious morbidity and fatality in this potentially treatable and curable disease.


Scrub typhus, Eschar, MODS, ARDS.

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