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Tsutsugamushi Hepatopathy: A Scoping Review.

Suprabhat Giri1, Dibya L Praharaj1, Anil C Anand1

  • 1Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India.

Journal of Clinical and Experimental Hepatology
|March 19, 2026
PubMed
Summary

Scrub typhus, an infectious disease caused by Orientia tsutsugamushi, frequently causes liver dysfunction. Early recognition of hepatic involvement is crucial for managing this significant public health concern.

Keywords:
acute hepatitisacute liver failureorientia tsutsugamushiscrub typhustropical fever

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Area of Science:

  • Infectious Diseases
  • Hepatology
  • Public Health

Background:

  • Scrub typhus, caused by Orientia tsutsugamushi, is a prevalent mite-borne illness in Asia.
  • Hepatic dysfunction is a common yet often overlooked manifestation of scrub typhus.
  • Clinical presentations range from elevated liver enzymes and jaundice to severe hepatic failure.

Purpose of the Study:

  • To review the literature on hepatic dysfunction in scrub typhus.
  • To understand the incidence, clinical features, and outcomes of liver involvement in scrub typhus patients.

Main Methods:

  • A scoping review of 63 studies was conducted.
  • Studies predominantly focused on scrub typhus cases in Asian populations.
  • Data on hepatomegaly, jaundice, and liver enzyme abnormalities were analyzed.

Main Results:

  • Incidence of hepatomegaly ranged from 2.5% to 98.5%, jaundice from 1.4% to 36.5%, and abnormal transaminases from 27.5% to 100%.
  • Hepatocellular damage was typical, with AST often exceeding ALT.
  • Hepatic dysfunction correlated with disease severity, increased hospitalization, and mortality.

Conclusions:

  • Hepatic dysfunction is a significant clinical feature of scrub typhus with multifactorial causes.
  • Early detection and management of liver involvement are vital for improving patient outcomes.
  • This condition impacts disease severity and prognosis in both adults and children.