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A Review of Rickettsial Diseases Other Than Scrub Typhus in India

Sivanantham Krishnamoorthi1, Shriya Goel2, Jasleen Kaur2

  • 1Department of Microbiology, All India Institute of Medical Sciences, Bathinda 151001, India.

Tropical Medicine and Infectious Disease
|May 26, 2023
PubMed

Insights

Rickettsial diseases other than scrub typhus are common in India but often overlooked. This review examines the epidemiology, clinical presentation, and diagnostic challenges of non-scrub typhus rickettsial diseases in India.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Medical Microbiology

Background:

  • Rickettsial diseases (RD) are globally prevalent, with scrub typhus (ST) being a significant tropical infection well-documented in India.
  • Physicians maintain a high index of suspicion for ST in patients with acute febrile illness (AFI) and acute undifferentiated febrile illness (AUFI) in India.
  • Rickettsial diseases other than ST (non-ST RDs), including spotted fever group (SFG) and typhus group (TG) rickettsioses, are also prevalent in India.

Purpose of the Study:

  • To review the Indian epidemiological landscape of non-ST RDs, focusing on SFG and TG rickettsioses.
  • To explore the clinical presentation spectrum of these infections.
  • To identify challenges and knowledge gaps in suspecting and diagnosing non-ST RDs in India.

Main Methods:

  • Literature review of investigations and case reports on non-ST RDs in India.
  • Analysis of epidemiological data and clinical findings.
  • Identification of diagnostic and clinical challenges.

Main Results:

  • Non-ST RDs, particularly SFG and TG rickettsioses, are not uncommon in India.
  • Lower index of suspicion for non-ST RDs compared to ST, often requiring specific symptoms like fever with rashes or arthropod bites for consideration.
  • Limited data and diagnostic challenges hinder accurate identification and management.

Conclusions:

  • There is a need to increase awareness and diagnostic suspicion for non-ST RDs among healthcare professionals in India.
  • Further research is required to understand the true burden and spectrum of these diseases.
  • Improved diagnostic strategies and clinical recognition are crucial for effective management of non-ST RDs in India.
Keywords:
Indiadiagnosisepidemiologyspotted fever group rickettsiosestyphus group rickettsioses

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