Analysis of Two Outbreaks of Scrub Typhus in Rajasthan: A Clinico-epidemiological Study

To describe the diversity of clinical manifestations, laboratory findings and outcome of scrub typhus in hospitalised patients of SMS Hospital, Jaipur during 2012 and 2013.

All the cases of febrile illness with thrombocytopenia diagnosed as scrub typhus were analysed. Diagnosis was made by ELISA based IgM serology.

A total of 125 patients were studied. All of them presented with fever; the other major symptoms were headache, cough, dyspnoea and myalgias. On examination, patients had hepatosplenomegaly, lymphadenopathy and eschar. On investigation elevated SGOT, SGPT with normal or elevated bilirubin levels were the most common findings. Other laboratory findings were thrombocytopenia and deranged renal function tests. Most common X-ray finding observed in these patients was bilateral lung infiltrates. Other complications were MODS, ARDS, hypotension and meningoencephalitis. Majority responded to doxycycline.

Scrub typhus though prevalent is under-reported in our country. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, and B/L chest opacities. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.