Unresolved Problems Related to Scrub Typhus: A Seriously Neglected Life-Threatening Disease

Paris, Daniel; Shelite, Thomas R.; Day, Nicholas P. J.; Walker, David H.

doi:10.4269/ajtmh.13-0064

Cited by 287 publications

(298 citation statements)

References 88 publications

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“…This disease is treatable with antibiotics (5), but a delay in antibiotic treatment increases the risk of severe complications (6). Furthermore, the mortality rate of untreated patients is estimated to be 10z (5).…”

Section: Communicated By Masayuki Saijomentioning

confidence: 99%

A Case of Scrub Typhus Imported from South Korea to Yamagata, Japan

et al. 2016

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Section: Communicated By Masayuki Saijomentioning

confidence: 99%

A Case of Scrub Typhus Imported from South Korea to Yamagata, Japan

et al. 2016

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“…2 The so-called "tsutsugamushi triangle" region, which extends from northeast Asia to Papua New Guinea and northern Australia in the southeast, Pakistan and Afghanistan in the northwest, and the Maldives and Réunion Islands in the southwest, is endemic for scrub typhus with around 2 million of the population at risk. [3][4][5] The disease has become a significant occupational hazard in rural workers, adults involved in agriculture, forest occupation, soldiers in temporary camps, and in those living close to bushes and wood piles. 5 In recent years, scrub typhus has rapidly remerged to become the major cause of AFI in many parts of India, especially during the monsoon and postmonsoon seasons.…”

Section: Introductionmentioning

confidence: 99%

Scrub Typhus in a Tertiary Care Hospital in North India

Sharma

Biswal

Kumar

et al. 2016

The American Society 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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“…It also has diagnostic advantage over serology in endemic areas with high background levels of antibody in the population. However, the high resource costs and training requirement make them impractical in many endemic areas [27]. Considering the drawbacks of these techniques individually, it has been recommended that point of care testing should be developed including both pathogen and antibody based tests.…”

Section: Need Of Newer Techniques For Rapid and Accurate Diagnosismentioning

confidence: 99%