title: Scrub typhus in Punjab: an acute febrile illness with multisystem involvement.
abstract: Scrub typhus is an important cause of acute febrile illness. This observational study describes the clinical features and complications of the patients diagnosed to have scrub typhus in Christian Medical College & Hospital, Ludhiana, Punjab, India. The diagnosis of scrub typhus was made by using Bioline SD Tsutsugamushi test kit which detects IgM, IgG or IgA antibodies to Orientia tsutsugamushi. Sixty-two patients of scrub typhus were seen during the study period of 1 year. The mean age of the study group was 39.9 years. All the patients presented with fever, and of these 31 (50%) had non-specific symptoms. All others had some complication, namely ARDS/ALI in 18 (29%), neurological involvement in 12 (19.4%), acute kidney injury (AKI) in 16 (25.8%), hypotension in eight (12.9%), thrombocytopenia in 23 (37.1%), hepatitis in 34 (54.8%) and MODS in 19 (30.7%). Eschar was present only in nine patients. Three patients expired due to multi-organ failure, hypotension and metabolic acidosis.
authors.affiliation: Assistant Professor, Department Of Medicine, Christian Medical College & Hospital, Ludhiana, Punjab, India loombavikas123@yahoo.co.in.
authors.forename: Vikas
authors.initials: V
authors.lastname: Loomba
authors.affiliation: Professor, Department Of Medicine, Christian Medical College & Hospital, Ludhiana, Punjab, India.
authors.forename: Anna
authors.initials: A
authors.lastname: Mani
authors.affiliation: Professor & Head, Department of Medicine, Christian Medical College & Hospital, Ludhiana, Punjab, India.
authors.forename: Mary
authors.initials: M
authors.lastname: John
authors.affiliation: Professor & Head, Department of Microbiology, Christian Medical College & Hospital, Ludhiana, Punjab, India.
authors.forename: Aroma
authors.initials: A
authors.lastname: Oberoi
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005334:Fever / Q000209:etiology*; D006505:Hepatitis / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology; D012285:Orientia tsutsugamushi / Q000302:isolation & purification; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013921:Thrombocytopenia / Q000209:etiology; D055815:Young Adult
keywords: ARDS; Acute febrile illness; MODS; Rickettsial infection