title: Outbreak of scrub typhus in Andhra Pradesh--experience at a tertiary care hospital.
abstract: OBJECTIVE
  To describe the clinical features, laboratory manifestations, complications in patients diagnosed with scrub typhus at a tertiary care hospital in south India.
  
  
  METHODS
  All cases of acute onset fever diagnosed to have scrub typhus August 2011 to December 2012 were analysed. Cases of scrub typhus confirmed by the well felix test with a titre of 1 in 80 or more and a positive immunochromatography test were studied.
  
  
  RESULTS
  176 confirmed cases of scrub typhus were studied over a period of 18 months. Majority (96%) of patients are from rural background. Farmers constituted 60% of the patients. Most common symptoms were due to the involvement of respiratory tract in the form of cough in 94 (53%) patients followed by breathlessness in 84 (47.7%). Signs of consolidation were seen in 80 (45.5%). Central nervous system involvement in the form of altered sensorium was seen in 43 (24.4%) and seizures in 11 (6.3%) patients. Eshcar was seen in 23 (13%) patients. Transaminases were elevated in 153 (86%) patients, serum alkaline phosphatase in 110 (62.5%) patients. Renal failure was seen in 49 (27.8%) cases and respiratory failure was seen in 11 (6.2%). Eight (4.5%) patients died in our study.
  
  
  CONCLUSIONS
  Scrub typhus should be suspected in patients with rural background with fever and multi system involvement. The predominant symptoms were cough and breathlessness. Central nervous system abnormalities in the form of altered sensorium was seen in 43 (24.4%). Most common laboratory abnormality noted in our patients with scrub typhus was elevated liver enzymes which were seen in 153 (86%) cases.
authors: M V S
authors: MV
authors: Subbalaxmi
authors: Murali Krishna
authors: MK
authors: Madisetty
authors: A Krishna
authors: AK
authors: Prasad
authors: V D
authors: VD
authors: Teja
authors: K
authors: K
authors: Swaroopa
authors: Naval
authors: N
authors: Chandra
authors: A C
authors: AC
authors: Upadhyaya
authors: Mallikarjuna
authors: M
authors: Shetty
authors: M N
authors: MN
authors: Rao
authors: Y S
authors: YS
authors: Raju
authors: Vemu
authors: V
authors: Lakshmis
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012612:Scrub Typhus / Q000453:epidemiology*; D063128:Tertiary Health Care