Standard operating protocol for Scrub typhus diagnosis and treatment

Scrub typhus is increasingly recognised as a common cause of acute febrile illness in South and Southeast Asia. A lack of clinical suspicion and delayed diagnosis contribute to a mortality rate of ∼10%. A clinical diagnosis based on seasonal epidemiology, presence of eschar or rash, thrombocytopenia, hepatic or splenic involvement, and multiorgan dysfunction warrants prompt empirical treatment with doxycycline or azithromycin. IgM enzyme-linked immunosorbent assay remains the diagnostic mainstay. Treatment is stratified by severity; dual therapy is recommended in severe, confirmed cases. Most patients respond within 48 h of antibiotic initiation.