Predictors of Severity in Scrub Typhus

Area of Science:

• Infectious Diseases
• Tropical Medicine
• Clinical Microbiology

Background:

• Scrub typhus, a potentially severe febrile illness, is caused by Orientia tsutsugamushi.
• Early diagnosis and understanding of severity predictors are crucial for patient management and improving outcomes.

Purpose of the Study:

• To identify clinical and laboratory predictors associated with severe scrub typhus in patients admitted to a tertiary care hospital.
• To analyze factors correlating with organ failure and mortality in scrub typhus.

Main Methods:

• A study was conducted on 92 scrub typhus patients diagnosed via Indirect Immunofluorescence Assay (IFA).
• Clinical features, laboratory findings, hospital course, and outcomes were documented.
• Statistical analysis was performed to identify factors associated with severe disease and mortality.

Main Results:

• Common symptoms included fever, cough, and headache. Eschar was present in 23% of patients.
• Laboratory findings revealed elevated transaminases (61%), thrombocytopenia (39%), and leukocytosis (30%).
• Severe sepsis occurred in 33%, septic shock in 4%, and organ failure in 34%. Leukocytosis, hyperbilirubinemia, high SGOT, hypoalbuminemia, high urea, and high creatinine were significantly associated with organ failure and mortality.

Conclusions:

• Scrub typhus can lead to life-threatening complications including meningoencephalitis, septic shock, ARDS, acute liver failure, and acute kidney injury.
• Leukocytosis, hyperbilirubinemia, transaminitis, hypoalbuminemia, and uremia are significant predictors of organ failure, morbidity, and mortality in scrub typhus.