Scrub Typhus in Himalayas

Mahajan, S.; Rolain, Jean‐Marc; Kashyap, Rajesh; Bakshi, Diprabhanu; Sharma, Vijay Prakash; Prasher, B S; Pal, Lal Singh; Raoult, Didier

doi:10.3201/eid1210.051697

Cited by 160 publications

(177 citation statements)

References 9 publications

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“…30,31 A maculopapular rash, as a presenting feature, was seen in 9% of our patients, as compared with 22% patients from Vellore, 20% patients from the Himalayan region of north India, 30% patients in Thailand, and 55.7% patients from Jeju Islands, South Korea. [23][24][25][26][27][28][29][30][31][32] In the present study, splenomegaly was present in 45% of patients. Another study from north India has reported a higher splenomegaly rate of 59%.…”

Section: Discussionmentioning

confidence: 80%

“…[12][13][14][15][16][17][18][19][20][21][22] The pathognomonic eschar was present in 14% patients (Table 3), a figure considerably higher than a previous study from the Himalayan region (9.5% patients), but lesser than that reported from south India (43.5%) and Jeju Island in South Korea (75.8%). 26,28,29 This variation in the presence of eschar may be explained by the geographic distribution of different strains of the organism. Lymphadenopathy, present in a nearly 11% third of our patients, was also lesser than in the studies from Vietnam and Thailand.…”

Section: Discussionmentioning

confidence: 99%

“…23 ARDS occurred in 25% in our study, whereas earlier studies have reported ARDS in 8-34%. 23,27,28 An intensive care unit (ICU) study from south India has shown ARDS (96%) as the most common indication among scrub typhus patients requiring admission to their ICU. 26 Acute kidney injury was noted in 32% of our scrub typhus patients, which is lower than the previous study from our center reporting 53% of cases with renal failure.…”

Section: Discussionmentioning

confidence: 99%

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Scrub Typhus in a Tertiary Care Hospital in North India

Sharma

Biswal

Kumar

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. Scrub typhus, a zoonotic disease caused by the bacterium Orientia tsutsugamushi, has become endemic in many parts of India. We studied the clinical profile of this infection in 228 patients that reported to this tertiary care center from July 2013 to December 2014. The median age of patients was 35 years (interquartile range = 24.5-48.5 years), and 111 were males and 117 females. A high-grade fever occurred in 85%, breathlessness in 42%, jaundice in 32%, abdominal pain in 28%, renal failure in 11%, diarrhea in 10%, rashes in 9%, and seizures in 7%. Common laboratory abnormalities at presentation were a deranged hepatic function in 61%, anemia in 54%, leukopenia in 15%, and thrombocytopenia in 90% of our patients. Acute kidney injury (32%), acute respiratory distress syndrome (ARDS) (25%), and disseminated intravascular coagulation (DIC) (16%) were the commonest complications. A hepatorenal syndrome was seen in 38% and multiple organ dysfunction syndrome (MODS) in 20% patients. The overall case fatality rate was 13.6%. In univariate analysis, ARDS requiring mechanical ventilation, acute kidney injury requiring hemodialysis, hypotension requiring inotropic support, central nervous system dysfunction at presentation, and MODS were inversely associated with survival.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Scrub Typhus in a Tertiary Care Hospital in North India

Sharma

Biswal

Kumar

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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“…3 Moreover, an increasing incidence of scrub typhus has been reported in some Asian countries. 4 The incidence of scrub typhus may be related to temperature, rainfall, and socioeconomic factors. 5,6 The first Korean case of scrub typhus was reported in 1985.…”

Section: Introductionmentioning

confidence: 99%

Effect of Latitude and Seasonal Variation on Scrub Typhus, South Korea, 2001–2013

Jeung¹,

Kim²,

Yun³

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. In South Korea, scrub typhus is one of the most common rickettsial diseases. The number of scrub typhus patients has increased in South Korea, a total of 69,210 cases were reported from 2001 to 2013. The seasonality and relation of scrub typhus cases to latitude were analyzed in this article using data obtained from the National Notifiable Diseases Surveillance System website of the Korea Centers for Disease Control and Prevention. The incidence of scrub typhus tended to increase in the later months of the year, especially in October-December. In general, lower latitudes were associated with a later peak incidence. Our results suggest for the first time that the monthly observed incidence tended to increase in the later months of the year as the latitude decreased, and on a yearly basis in Korea.

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“…It is endemic to a large area of the Asia-Pacific rim, extending from Afghanistan to China, Korea, the islands of the south-western Pacific, and northern Australia [8]. In India also, there are reports from various regions including Himalayas [9,10], Rajasthan [11] and South India [12] either as retrospective case studies or outbreak investigations with high incidence of complications and mortality from the disease [10,11].…”

Section: Introductionmentioning

confidence: 99%