Changing Trends in the Clinical Suspicion of Scrub Typhus in Acute Febrile Illness Patients

Changing Trends in the Clinical Suspicion of Scrub Typhus in Acute Febrile Illness Patients

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Introduction: Scrub typhus is an important and widespread cause of acute febrile illness (AFI), which can be diagnosed easily by serological assay.Methods: All cases of AFI were sent for Scrub Typhus serology by rapid Enzyme Linked Immuno-Sorbent Assay (ELISA) method.Anyone found positive Pine Bark Extract/Pycnogenol was admitted for further evaluation.Results: In this series 80 % had liver abnormality, 80 % had ARDS, 40 % had renal failure, 40 % had eschar and 80 % of them had MODS.

Only 20 % had clinical features of encephalitis with MRI brain haemorrhagic transformation of infarct.All patients responded well to treatment with Doxycycline with hospitalization of around 7-10 days.Conclusion: This case series highlights the importance of keeping a Half Zip high index of clinical suspicion to exclude scrub typhus in all AFI patients.