Case reports: scrub typhus during pregnancy in India.
Scrub typhus, caused by Orientia tsutsugamushi, is a rural zoonosis endemic in the Asian Pacific region. Doxycycline and chloramphenicol, the recommended drugs for treating this infection, may not be safe during pregnancy. We report on 5 patients with scrub typhus during pregnancy who were seen in India between October 2001 and February 2002. Four of the 5 women were treated initially with ciprofloxacin. Three women had stillbirths, 1 an abortion and 1 a low birthweight baby, which suggests that ciprofloxacin should not be used for treating pregnant women and that scrub typhus leads to severe adverse effects during pregnancy. Randomized controlled trials are urgently needed to ascertain the optimal drug choice, given that currently recommended drugs are contraindicated in pregnant women.
Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
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E
Mathai
J M
JM
Rolain
L
L
Verghese
M
M
Mathai
P
P
Jasper
G
G
Verghese
D
D
Raoult
D000022:Abortion, Spontaneous / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D000075202:Contraindications; D005260:Female; D005313:Fetal Death / Q000139:chemically induced; D005317:Fetal Growth Retardation / Q000139:chemically induced; D006801:Humans; D008297:Male; D012285:Orientia tsutsugamushi; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012612:Scrub Typhus / Q000188:drug therapy*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin