Scrub Typhus in Adults – A Case Series from a Tertiary Care Hospital

Introduction: Scrub typhus is a zoonosis caused by the rickettsial bacteria Orientia tsutsugamushi. The disease in endemic in many parts of India and continues to be a public health problem. Materials and Methods: This study describes the clinical profile of eight consecutive scrub typhus positive cases admitted in a tertiary care hospital. After complete physical examination, complete blood count, liver function tests, renal function tests, urine analysis, blood & urine cultures were done in all cases. In all the cases, scrub typhus was diagnosed using a rapid single step immunochromatographic assay. Results: Of eight cases five were females and three were males. Fever was the chief present symptom in all the cases. Other signs and symptoms were headache, myalgia, cough, hepatosplenomegaly, abdominal pain and lymphadenopathy. Eschar was present in all the cases. Liver enzymes were elevated in all the patients. Hypotension, thrombocytopenia, hepatic dysfunction, hypoalbuminemia, hematuria and proteinuria were the complications observed. All cases were successfully treated with doxycycline and there was no mortality. Conclusion: Our report emphasizes the fact that a diagnosis of scrub typhus should be suspected when a patient presents with fever and laboratory evidence of liver dysfunction, as early detection of the disease could reduce morbidity and mortality.