Online ISSN: 2515-8260

CLINICAL PROFILE AND OUTCOME OF SCRUB TYPHUS PATIENTS ADMITTED IN BANKURA SAMMILANI MEDICAL COLLEGE & HOSPITAL

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Dr Subhrajyoti Mitra, Dr Sudipta Pal, Dr Suvamoy Pandit

Abstract

Introduction:The World Health Organization has dubbed scrub typhus as one of the world’s most underdiagnosed/underreported diseases that often requires hospitalization. Scrub typhus is a zoonotic, acute febrile illness that is endemic in the regional population, caused by Orienta. Tsutsugamushi, an obligate intercellular anaerobic bacterium, which was previously categorized in the Rickettsia genus, is naturally maintained in the mites of Leptotrombidiumgenus,belonging to the family Trombiculidae, by trans-ovarian transmission. Aims: In this cross sectional, observational, descriptive study, an attempt has been made to document and review the clinical profile and complications in diagnosed cases of scrub typhus in this regional population, thus helping to create a better clinical and laboratory profile of this re-emerging disease for clinicians to work with. Materials and Methods: It is a descriptive,crosssectional and analytical study. This Study was conducted from 18months at Department of General Medicine, BSMCH. Result: Headache was present in 41(77.4%) patients, myalgia/arthralgia were complained by 46(86.8%) patients. 13(24.5%) patients had Platelet count of <1.5lac/cmm. Incidence of significantly raised (3 fold) SGPT(>100U/L) was found in 10(18.9%) patients, and that of SGOT was found in 11(20.7%) patients. Among respiratory symptoms, cough was present in 17(32.1%) patients, shortness of breath was in 16(30.2%) . On respiratory system examination,15(28.3%) patients had bilateral decreased VBS (subsequently found to have either B/L plural effusion or ARDS or pneumonitis). 6(11.3%) patients had B/L Infiltrates in chest X Ray, 10(18.9%) patients had B/L pleural effusion . In our study, 2(3.8%) patients had Oliguria. On neurological examination, 5(9.4%) patients had clinical features suggestive of Meningitis, 3(5.7%) patients had features suggestive of Meningoencephalitis. 1(1.9%) patient was found to have focal neurodeficit in form of left lateral rectus palsy. Only 1(1.9%) patient presented with Eschar in left thigh and associated left inguinal lymphadenopathy Conclusion:We found that, in patients presenting with fever and respiratory symptoms having B/L infiltrate and/or B/L pleural effusion, suspicion of scrub typhus should be kept in mind.

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