Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India
Background & objectives: Scrub typhus is a neglected tropical disease common in Asia and Africa. It usually presents with non-specific symptoms like fever, rashes, and lymphadenopathy. It has a varying range of clinical picture that often leads to misdiagnosis and initiation of non-specific trea...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Vector Borne Diseases |
| Subjects: | |
| Online Access: | http://www.jvbd.org/article.asp?issn=0972-9062;year=2022;volume=59;issue=4;spage=380;epage=385;aulast=Verma |
| _version_ | 1797902909111795712 |
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| author | Shiva Verma Suruchi Shukla D Himanshu K K Sawlani Shantanu Prakash Amita Jain |
| author_facet | Shiva Verma Suruchi Shukla D Himanshu K K Sawlani Shantanu Prakash Amita Jain |
| author_sort | Shiva Verma |
| collection | DOAJ |
| description | Background & objectives: Scrub typhus is a neglected tropical disease common in Asia and Africa. It usually presents with non-specific symptoms like fever, rashes, and lymphadenopathy. It has a varying range of clinical picture that often leads to misdiagnosis and initiation of non-specific treatment. This disease is thus associated with high morbidity and mortality. We aim to highlight the uncommon presentations of this common disease to create awareness regarding the unusual presentations of scrub typhus.
Methods: This prospective study was performed over a period of two months enrolling eleven adult patients with serological evidence of anti-scrub typhus IgM antibodies.
Results: All enrolled 11 cases [5 males (45.5%) and 6 females (54.5%)] were positive for anti-ST IgM antibodies and negative for other tested microbial agents. 7/11 (63.6%) patients were admitted with a clinical diagnosis of acute encephalitis syndrome (AES as per standard WHO definition), 3/11 (27.3%) patients presented with jaundice and 1/11 (9.1%) patients presented with rashes. Two out of 7 (28.6%) AES cases had developed peripheral gangrene of extremities.
Interpretation & conclusion: Scrub typhus is a common tropical disease that can have various unusual clinical presentations like meningoencephalitis, vasculitis, acute kidney injury, jaundice, MODS. It closely mimics other infective etiologies making its diagnosis difficult. A high index of suspicion and clinical awareness is required in clinical practice to identify the different presentations of this disease so that early treatment can be initiated to reduce morbidity and mortality associated with this disease. |
| first_indexed | 2024-04-10T09:24:43Z |
| format | Article |
| id | doaj.art-c26579ccedf044948a215f9e2c5bd5ca |
| institution | Directory Open Access Journal |
| issn | 0972-9062 |
| language | English |
| last_indexed | 2024-04-10T09:24:43Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Vector Borne Diseases |
| spelling | doaj.art-c26579ccedf044948a215f9e2c5bd5ca2023-02-20T07:22:02ZengWolters Kluwer Medknow PublicationsJournal of Vector Borne Diseases0972-90622022-01-0159438038510.4103/0972-9062.355960Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north IndiaShiva VermaSuruchi ShuklaD HimanshuK K SawlaniShantanu PrakashAmita JainBackground & objectives: Scrub typhus is a neglected tropical disease common in Asia and Africa. It usually presents with non-specific symptoms like fever, rashes, and lymphadenopathy. It has a varying range of clinical picture that often leads to misdiagnosis and initiation of non-specific treatment. This disease is thus associated with high morbidity and mortality. We aim to highlight the uncommon presentations of this common disease to create awareness regarding the unusual presentations of scrub typhus. Methods: This prospective study was performed over a period of two months enrolling eleven adult patients with serological evidence of anti-scrub typhus IgM antibodies. Results: All enrolled 11 cases [5 males (45.5%) and 6 females (54.5%)] were positive for anti-ST IgM antibodies and negative for other tested microbial agents. 7/11 (63.6%) patients were admitted with a clinical diagnosis of acute encephalitis syndrome (AES as per standard WHO definition), 3/11 (27.3%) patients presented with jaundice and 1/11 (9.1%) patients presented with rashes. Two out of 7 (28.6%) AES cases had developed peripheral gangrene of extremities. Interpretation & conclusion: Scrub typhus is a common tropical disease that can have various unusual clinical presentations like meningoencephalitis, vasculitis, acute kidney injury, jaundice, MODS. It closely mimics other infective etiologies making its diagnosis difficult. A high index of suspicion and clinical awareness is required in clinical practice to identify the different presentations of this disease so that early treatment can be initiated to reduce morbidity and mortality associated with this disease.http://www.jvbd.org/article.asp?issn=0972-9062;year=2022;volume=59;issue=4;spage=380;epage=385;aulast=Vermagangrene; aes; mods; jaundice |
| spellingShingle | Shiva Verma Suruchi Shukla D Himanshu K K Sawlani Shantanu Prakash Amita Jain Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India Journal of Vector Borne Diseases gangrene; aes; mods; jaundice |
| title | Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India |
| title_full | Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India |
| title_fullStr | Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India |
| title_full_unstemmed | Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India |
| title_short | Unusual clinical presentations of scrub typhus, a neglected tropical disease: A case series from north India |
| title_sort | unusual clinical presentations of scrub typhus a neglected tropical disease a case series from north india |
| topic | gangrene; aes; mods; jaundice |
| url | http://www.jvbd.org/article.asp?issn=0972-9062;year=2022;volume=59;issue=4;spage=380;epage=385;aulast=Verma |
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