Eschar in Scrub Typhus: A Study from North East India
Md Jamil1, Prasanta Bhattacharya2, Jaya Mishra3
1Assistant Professor, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya.
The Journal of the Association of Physicians of India
|July 17, 2019
Summary
Eschar, a key sign in scrub typhus diagnosis, was present in 24.8% of patients. Those with eschar showed higher rates of multi-organ dysfunction, hepatitis, and lymphadenopathy, indicating its clinical significance.
Area of Science:
- Infectious Diseases
- Dermatology
- Clinical Medicine
Background:
- Eschar is a critical clinical indicator for early scrub typhus diagnosis.
- Prompt diagnosis facilitates timely treatment and complication prevention.
Purpose of the Study:
- To determine the prevalence and distribution of eschar in scrub typhus patients.
- To compare clinical manifestations and complications in patients with and without eschar.
Main Methods:
- Retrospective hospital-based study of adult patients in North-Eastern India.
- Scrub typhus diagnosis confirmed by clinical features and serological tests (ICT, IgM ELISA, Weil Felix).
- Statistical analysis using Chi-square test; p<0.05 considered significant.
Main Results:
- 129 scrub typhus patients studied; eschar found in 24.8% (9.3% multiple).
- Common eschar sites: inguinal (28.57%), trunk (25.75%), lower limbs (22.85%).
- Eschar presence significantly correlated with multi-organ dysfunction (p=0.008), hepatitis (p=0.005), and lymphadenopathy (p<0.01).
Conclusions:
- Eschar frequently occurs in the inguinal region, lower limbs, and trunk.
- Multi-organ dysfunction is more prevalent in scrub typhus patients presenting with eschar.
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