Thrombocytopenia to Reactive Thrombocytosis in Scrub Typhus- The Play of Platelets

Acharya, Sourya; Shukla, Samarth; Lahole, Swapnil; Mishra, Preeti

doi:10.7860/jcdr/2020/44102.13648

Cited by 3 publications

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“…Reactive thrombocytosis, which is another kind of thrombocytosis, was seen in five (2.43%) study samples. An increase in serum thrombopoietin due to thrombocytopenia stimulates the megakaryocytes in the bone marrow and raises the number of platelets in the blood [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India

Kumar Jana,

Krishna Mandal,

Gayen

et al. 2023

Cureus

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Background Scrub typhus is a reemerging, acute, undifferentiating febrile illness and one of the most neglected tropical diseases, calling for an in-depth investigation into its clinical diversity, complications, and mortality, which drives us to carry out this research work. Methods Over a year, prospective observational research was carried out after gaining parental consent and institutional ethical clearance, 206 children of either gender aged between one month and 12 years who had been hospitalized with a fever for at least five days and subsequently tested positive for Orientia tsutsugamushi were included in the study. Basic demographic information, clinical characteristics, laboratory findings, complications, related coinfections, and results were gathered and analyzed. A P -value of 0.05 was set as the statistical benchmark. Results The current study found that boys outnumbered girls. The ratio of boys to girls was 1.22:1, and the average age was 5.18 years. All had a fever (100%), and the other most frequently occurring clinical signs and symptoms were abdominal pain (16.99%), vomiting (22.33%), hepatosplenomegaly (49.51%), facial puffiness (39.32%), edema (27.18%), lymphadenopathy (19.90%), eschar (19.90%), macular-erythematous rash (17.96%), cough (21.84%), conjunctival congestion (25.24%), and headache (13.59%). Anemia (81.55%), leucocytosis (20.39%), leucopenia (6.8%), thrombocytopenia (49.51%), thrombocytosis (2.43%), and elevated serum levels of alanine aminotransferase (ALT, 57.28%) and aspartate aminotransferase (AST, 63.59%) were characteristic laboratory results. The coinfections were dengue, enteric fever, urinary tract infections, and malaria. Children who also had dengue were more likely to develop thrombocytopenia, which was statistically significant ( P -value = 0.008). With doxycycline medication, early defervescence of fever occurred earlier than with azithromycin, and it was statistically significant ( P -value = 0.000). The complications were hepatitis (63.59%), lower respiratory tract infections (LRTIs, 22.82%), scrub typhus meningoencephalitis (STME, 3.88%), acute kidney injury (AKI, 2.91%), myocarditis (1.46%), and acute disseminated encephalomyelitis (ADEM, 0.49%). Except for one who had ADEM, everyone was sent back home after receiving the best care possible. The average duration of hospital stay was 6.89 days. Conclusions Even in the absence of eschar, scrub typhus should be suspected in any febrile child who experiences clinical signs of meningoencephalitis syndrome, capillary leakage, skin rash, conjunctival congestion, LRTI, AKI, lymphadenopathy, hepatosplenomegaly, thrombocytopenia, and liver dysfunction in the post-monsoon season. Strong clinical suspicion and prompt anti-scrub drug administration go a long way in preventing or decreasing the morbidity and mortalit...

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Section: Discussionmentioning

confidence: 99%

Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India

Kumar Jana,

Krishna Mandal,

Gayen

et al. 2023

Cureus

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“…Scrub typhus has been recorded in rising numbers across India, particularly in the Himalayan foothills, Assam, West Bengal, and Tamil Nadu. Scrub typhus has resurfaced in numerous places in India, particularly South India, according to recent reports [ 4 ]. Scrub typhus is severely underdiagnosed in India due to its non-specific clinical presentation, doctors' lack of awareness and suspicion, and lack of diagnostic resources [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Scrub typhus is severely underdiagnosed in India due to its non-specific clinical presentation, doctors' lack of awareness and suspicion, and lack of diagnostic resources [ 7 ]. Empirical therapy with doxycycline or macrolides may be provided in situations where there is a high suspicion of scrub typhus since delay in treatment can result in serious life-threatening consequences [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Plasmodium falciparum, Vivax and Scrub Typhus in a Young Adult Male: Surviving a Triple Strike

Kota¹,

Kabra²,

Kumar³

et al. 2022

Cureus

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Malaria is caused by Plasmodium species and is called a "Rainy season disease". Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi. Both diseases occurring as co-infection are very rare. If a patient presents with a fever complaint, all the possible causes should be ruled out even if the patient shows infectivity for one of the vector-borne diseases. This case report shows the rare occurrence of the coinfection and its presentation. Early detection and timely management can prevent the patient from various fatal complications.

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Rickettsial epididymo-orchitis – An emerging threat in endemic areas

Guru

Patil

Kundargi

et al. 2020

J Datta Meghe Inst Med Sci Univ

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Thrombocytopenia to Reactive Thrombocytosis in Scrub Typhus- The Play of Platelets

Cited by 3 publications

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Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India

Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India

Plasmodium falciparum, Vivax and Scrub Typhus in a Young Adult Male: Surviving a Triple Strike

Rickettsial epididymo-orchitis – An emerging threat in endemic areas

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