Clinical Profile of Scrub Typhus Patients in a Tertiary Care Hospital in Kerala

Scrub typhus is one of the reemerging Rickettsial diseases in India. The disease is spread to people by the bite of a mite infected with larval trombiculid mite. The objective of this study was to study the clinical profile and outcome of Scrub Typhus patients. Since scrub typhus was newly reported disease from this part of the country, the providers may not be familiar with the clinical pictures.

This study retrospectively reviewed the clinical records of patients admitted to government medical college, Kozhikode, a tertiary care centre in Kerala, during 2011 with positive Weil-Felix test and/or presence of eschar.

Thirty-two scrub typhus patients were admitted to the hospital during one year period (2011). Maximum number of patients were in the age group of 46–60 yrs. Major symptoms include fever(100%), headache(50%), myalgia (47%), vomiting(28%), cough(25%) and decreased urine output(22%), yellow coloured urine(15.6%) & breathlessness(12.5%). Eschar alone was present in a total of six patients(18.8%). Weil-Felix test alone was positive in a total of 25(78.1%) subjects. One patient had both eschar and Weil-Felix positivity. Common complications were ARDS(6/32), Meningoencephalitis(5/32), Myocarditis(4/32) Renal involvement and many patients developed multisystem involvement (6/32). One patient with multiorgan involvement died.

Scrub typhus should be considered in the differential diagnosis of patients with acute febrile illnesses with a wide range of symptoms. Scrub typhus should be considered in the differential diagnosis of Leptospirosis, Typhoid, Dengue, Malaria. Empirical therapy with Doxycycline may be life-saving when clinical suspicion is high.