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Clinical and Laboratory Predictors associated with Complicated Scrub Typhus.
Mi Hee Kim1, Si Hyun Kim1, Jung Hyun Choi1
1Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Infection & Chemotherapy
|July 5, 2019
Summary
Scrub typhus can lead to severe illness, with hepatic dysfunction being the most common complication. Absence of skin rash, elevated adenosine deaminase (ADA), and ferritin levels are key predictors of severe scrub typhus and prolonged hospitalization.
Area of Science:
- Infectious Diseases
- Epidemiology
- Internal Medicine
Background:
- Scrub typhus, caused by *Orientia tsutsugamushi*, is a significant mite-borne illness in Asia-Pacific regions.
- It is a common cause of febrile illness in Korea, particularly during autumn.
- Understanding risk factors for severe scrub typhus is crucial for timely intervention.
Purpose of the Study:
- To identify predictors for severe scrub typhus.
- To analyze clinical and laboratory differences between elderly and non-elderly scrub typhus patients.
- To investigate factors associated with prolonged hospitalization.
Main Methods:
- Retrospective review of medical records for scrub typhus patients.
- Statistical analysis to identify independent predictors of severe disease and prolonged hospitalization.
Main Results:
- Hepatic dysfunction (10.7%) was the most frequent complication of severe scrub typhus.
- Independent predictors for severe scrub typhus included absence of skin rash, elevated adenosine deaminase (ADA) (≥100 IU/L), and elevated ferritin (≥500 ng/mL).
- Absence of skin rash, pulmonary edema, elevated serum creatinine, total bilirubin, ADA, and ferritin were linked to longer hospital stays.
Conclusions:
- Several independent predictors for complicated scrub typhus were identified.
- Absence of skin rash, elevated ADA, and ferritin levels predict severe scrub typhus.
- These predictors also correlated with prolonged hospitalization durations.
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