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Scrub typhus a zoonotic disease, caused by the intracellular parasite Orienta tsutsugamushi, transmitted by the bite of trombiculid mite. It is under reported in Odisha, may be due to lack of suspicion and / lack of specific diagnostic test.
To describe the diverse clinical and laboratory manifestations of scrub typhus patients admitted into the adult tertiary critical care unit at Apollo Hospitals, Bhubaneswar.
All cases of febrile illness diagnosed as scrub typhus over a period of 9months from June 2014-Feb 2015 were analyzed. Diagnosis was based on the presence of the eschar and /or positive by IgM enzyme-linked immunosorbent assay (Sensitivity 93% and specificity 98%).
During the study period 40 cases of scrub typhus were detected and most of them presented with fever (100%), headache (80%), cough and dyspnea (65%). Eschar was detected in 12% cases. Mechanical ventilation (Invasive-18.5%, Non-invasive-81.5%) applied in 65% (n = 26) cases. All patients were managed with either doxycycline (n = 13; 32.5%) or doxycycline with azithromycin (n = 27; 67.5%). Among the patients 92.5% (n = 21) survived and 7.5% (n = 3) died.
Scrub typhus has emerged as an important cause of febrile illness in Odisha. Empirical treatment with doxycycline is justified in endemic areas.