Online ISSN: 2515-8260

Keywords : Acute febrile illness

To study causative agents and outcome in patients of acute febrile illness

Dr. Niraj Kumar Chaudhary, Dr. Ajeet Pratap Singh, Dr. Azhar Ali Khan, Dr. Shoolpani Mishra, Dr. Anshu Singh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 4791-4801

Acute febrile illness is a major public health problem in north-eastern Uttar Pradesh and the adjoining regions of Bihar and Nepal. It leads to heavy morbidity and mortality. This study aims to find out what causes Multiple Organ Dysfunction Syndrome (MODS), how it shows up in a patient's body, and what other factors lead to it in our tertiary care hospital in the Eastern UP.
Methodology: This observational study was done over one academic year (January 2018 to December 2018) with 200 patients attending the department of medicine at Nehru Hospital, B.R.D. Medical College, Gorakhpur.
Results: In our study, mortality in MODS was significant in scrub typhus and without MODS was significant in dengue patients. It was found that serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and serum creatinine changes had significant p-value (.0001) for MODS patients.
Conclusion: Out of known etiologies, 17.5% of scrub typhus, 10% of dengue, 2.5% of malaria, enteric fever dot, and sepsis can be prevented by educating people and taking preventive measures. Early hospitalisation and proper treatment can prevent these complications.

Cross Reactivity of Dengue, Scrub Typhus and Malaria among COVID-19 Positive Patients: A Tropical World Threat & A Sero-Diagnostic Challenge

Kumari Seema, Abhay Kumar, Manoj Kumar, Manju Boipai, Ashok Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5965-5970

Purpose: Diagnosis of acute undifferentiated febrile illness (AUFI) has been a challenge and burden in clinical practice in the tropics. COVID-19 cases that present with fever alone may be difficult to distinguish from other AUFIs in the tropics. Malaria, Scrub Typhus and Dengue fever are among the most common endemic diseases in the tropics. With the availability of rapid sero-diagnostic tests for these infections, it has been observed that patient’s samples frequently show seropositivity for two or more infections posing challenges in clinical diagnosis and treatment. This study was performed to determine the false-positive serological test (seropositivity) in COVID-19 patients for Scrub typhus, Dengue and Malaria.
Materials and Methods: The present study was a type of observational prospective study conducted from April 2020 to November 2020. A total of 574 febrile patients which were positive in Real time PCR for Covid-19, were included in the study.
Results: Dengue IgM antibody positive for 124, Scrub typhus IgM antibody positive in 107 and no positive in malarial test, were found.
Conclusion: Our experience suggests that false-positive in the serological test should be interpreted with caution and requires surveillance. There should be a continuous follow-up of these patients during COVID-19 pandemic and the importance of recognising false positive serological results in patients with COVID-19, especially in the resource-constrained tropical settings.

Acute undifferentiated fever in children: Clinical and Etiological profile

Dr. JayalakshmiNalavath, Dr. Kishore Kumar Pydi, Dr. Maheswar Earenti, Dr. Krishna Kishore V.R.V

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1029-1034

Introduction: Acute febrile illness (AFI) is defined as a patient with fever of 38°C or higher
at presentation or history of fever that persisted for 2-14 days with no localizing source. Fever
is the main clinical symptom of various tropical infectious diseases [1].
Materials and Methods: This is a Prospective and observational study was conducted at
Paediatric Department, Gayatri Vidya Parishad Institute of Health Care and Medical
Technology over a period of 1 year. Acute febrile illness (AFI) is defined as a patient with
fever of 38°C or higher at presentation or history of fever that persisted for 2-14 days with no
localizing source. Details of history and results of a thorough physical examination were
entered on a standard data collection sheet.The routine baseline investigations included
complete blood count analysis, serum electrolytes, liver and renal function tests.
Result: In this study typhoid fever was the most common cause of undifferentiated fever
(28.3%) followed by malaria (21.6%), dengue fever (19.1%), Acute gastroenteritis (14.1%),
Pneumonia (9.1%), Bronchiolitis (5.0%), Hepatitis (1.6%) and Pharyngotonsillitis
(0.8%%). Treatment-Enteric fever was treated with Ceftriaxone. Chloroquine was used for
treatment of Malaria. Dengue was treated symptomatically and with fluids according to
Dengue protocol. If fever persisted even after 6 days of antibiotics, then Azithromycin was
added. In the undiagnosed fever category, received empirical antibiotics.
Conclusion: A high prevalence of Typhoid, malaria and dengue in this study. The overlap
probably reflects an undefined level of previous infections, cross reactivity and subclinical
infections in the population, rather than high prevalence of coinfections.