Acute respiratory failure in scrub typhus patients

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Pulmonology

Background:

• Scrub typhus, a zoonotic disease caused by Orientia tsutsugamushi, can lead to severe complications.
• Acute respiratory failure is a significant cause of morbidity and mortality in scrub typhus patients admitted to the Intensive Care Unit (ICU).

Purpose of the Study:

• To investigate the clinical characteristics and outcomes of scrub typhus patients experiencing acute respiratory failure.
• To identify factors associated with the development of respiratory failure in scrub typhus.

Main Methods:

• A prospective study included 55 scrub typhus patients admitted to a single-center ICU.
• Demographic, clinical, laboratory, and imaging data were collected at ICU admission.
• Patients were categorized based on the presence or absence of acute respiratory failure.

Main Results:

• Of 55 patients, 27 (49%) developed acute respiratory failure, including 17 with acute respiratory distress syndrome and 10 with cardiogenic pulmonary edema.
• Patients with respiratory failure were older, had more chronic lung disease, and higher illness severity scores (APACHE-II, SOFA).
• They also exhibited more deranged laboratory markers (elevated bilirubin, CK, lactate; metabolic acidosis; low albumin; ascites) and longer ICU/hospital stays.

Conclusions:

• Nearly half of scrub typhus patients in the ICU develop acute respiratory failure.
• Older age, chronic lung disease, and severe illness markers predict respiratory failure in scrub typhus.
• Respiratory failure in scrub typhus is associated with increased mortality and resource utilization.