Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome

Abstract

The presentation of scrub typhus can be variable, often non-specific, but with potentially severe multi-organ dysfunction. Prompt recognition is key to specific treatment and good outcomes. Further study of the circulating strains is essential for the development of a successful vaccine and sensitive point-of-care testing.

Scrub Typhus in a Tertiary Care Hospital in North India

“…Nearly one-fourth of our patients presented with altered sensorium, similar to other studies. [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.…”

“…A late presentation, delay in diagnosis and treatment, and varying levels of antibiotic resistance exhibited by the organism are factors responsible for high mortality. 12 With the changing epidemiology of scrub typhus, it is now among the commonest causes of AFI in India. It is important to get familiar with the clinical and diagnostic laboratory features of scrub typhus, so as to differentiate it from other etiologies of AFI.…”

An unusual cause of simultaneous bilateral spontaneous pneumothorax

“…The severity of illness varies from mild to multi organ involvement causing high mortality. [5,6] Scrub typhus involves multiple organs, histologically characterized by microangiopathies. Pulmonary manifestations include varying degrees of interstitial pneumonitis progressing to acute respiratory distress syndrome, consolidation, pulmonary oedema, focal atelectasis, reticulonodular opacities, bronchial wall thickening, centrilobular nodules and hilar adenopathy.…”

Flekktyfus i Asia

“…Flekktyfus forårsaket av bakterien Orientia tsutsugamushi, såkalt kratt-tyfus (scrub typhus), er endemisk i Sørøst-Asia og ble omtalt av Verdens helseorganisasjon i 1999 som «trolig en av de mest underdiagnostiserte årsakene til innleggelse med feber i området» (1). Sykdommen har siden vist økende insidens (1), og årlig rammes nesten én million mennesker (2). Smittemåte er gjennom bitt av middlarver.…”

“…Nå har den samme forskergruppen undersøkt om dette også gjelder etter at pasientene har redusert sitt inntak av kortkjedede karbohydrater, ofte omtalt som FODMAP, som absorberes dårlig i tynntarmen og gjaeres lett av mikrober i tykktarmen og som derfor kan fremkalle mageplager (2).…”