Unveiling the spectrum of manifestations of scrub typhus: A study from a tertiary care teaching hospital of Kolkata, West Bengal

• Author Details:   
• Cizarina Roy
• Kabita Choudhury
• Subrata Datta
• Suman Kundu
• Ankita Banik
• Swagata Ganguly Bhattacharjee ^*

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Introduction: Scrub typhus presents with features of acute undifferentiated febrile illness (AUFI), like fever with chills, malaise, and headache, making differentiation difficult from other causes of AUFI. This remains one of the underdiagnosed and underreported causes of febrile illness in tropical countries.

Aims and Objectives: The study was conducted to assess the socio-demographic profile of scrub typhus admitted patients and to assess the spectrum of clinical manifestations and laboratory parameters in these patients

Materials and Methods: This observational cross-sectional study was conducted between February 2021 to January 2024 in the Department of Microbiology at NRS Medical College and Hospital, among patients admitted with AUFI who were scrub typhus IgM reactive

Results: During our study period, among 10,547 AUFI patients 10% (n=1024) were scrub typhus IgM reactive. Most patients belonged to the 0-20 year’s age group. There was a distinctive surge of cases in the rainy season. The hallmark sign, “eschar,” was absent in the majority of cases. Among the pediatric patients, central nervous system involvement was marked, but among the adult’s respiratory system was mainly affected. In our study adverse outcome was observed in 2.55% (n=26) patients.

Conclusion: Scrub typhus presents significant diagnostic challenges due to its diverse and nonspecific clinical manifestations. High case fatality was observed among cases with multi-organ dysfunction, among whom the diagnosis was delayed. Hence, early initiation of appropriate antibiotic therapy is critical, as it can significantly reduce disease duration, prevent complications, and ultimately decrease morbidity and mortality.