Tsutsugamushi Hepatopathy: A Scoping Review

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.