Clinical Profile, Outcomes, and Prognostic Factors of Scrub Typhus: A Prospective Observational Study.

Chalil; Abhipsa Mohapatra; Mohan Khetra Tudu; Kumar Prafulla Bariha; Kumar Manoj Mohapatra

doi:10.51168/rhxs3656

Authors

Gayathri Chalil Senior Resident, Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar
Abhipsa Mohapatra Asst. Prof. Dept. of Microbiology, SUM Hospital, Bhubaneswar, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India. 768017, SUM Hospital, Bhubaneswar
Khetra Mohan Tudu Asst.Prof. Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar
Prafulla Kumar Bariha Associate.Prof. Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswa.
Manoj Kumar Mohapatra Retd. Prof. Dept. of Medicinem, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar

DOI:

https://doi.org/10.51168/rhxs3656

Keywords:

Scrub typhus, Acute febrile illness, Orientia tsutsugamushi, Eschar, Prognostic factors, Doxycycline

Abstract

Background

Scrub typhus is an important cause of acute febrile illness in India and may lead to severe complications, including acute kidney injury and multiple organ dysfunction syndrome. Early identification of patients at risk of severe disease is essential for timely management. This study evaluated the clinical profile, outcomes, and prognostic factors of scrub typhus among adults in Odisha.

Methods

This hospital-based prospective observational study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Odisha, India, from November 2020 to January 2023. Adults diagnosed with scrub typhus using IgM enzyme-linked immunosorbent assay (ELISA) were included. Demographic characteristics, clinical findings, laboratory parameters, complications, and outcomes were recorded. Data were analysed using SPSS version 22. Continuous variables were summarized using means and standard deviations. Univariate analysis was performed to assess factors associated with severe disease.

Results

Among 985 patients admitted with fever, 110 (11.2%) were diagnosed with scrub typhus. Eschar was identified in 42 patients (38.2%), and complications occurred in 24 (21.8%). Four patients (3.6%) died, all with multiple organ dysfunction syndrome. Factors associated with severe disease included serum albumin below 2.8 g/dL, urine output below 500 mL/24 hours, leukocytosis above 10,000/µL, a fever-to-treatment interval exceeding 6 days, and serum creatinine above 3.8 mg/dL.

Conclusion

Scrub typhus was associated with substantial morbidity in this hospital-based cohort. Early diagnosis and recognition of clinical and laboratory indicators of severe disease may support timely management.

Author Biographies

Gayathri Chalil, Senior Resident, Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar

is a Senior Resident in the Department of Medicine with a special interest in infectious diseases, tropical medicine, and clinical epidemiology. Her research focuses on acute febrile illnesses, rickettsial infections, and evidence-based management of infectious diseases.
Abhipsa Mohapatra, Asst. Prof. Dept. of Microbiology, SUM Hospital, Bhubaneswar, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India. 768017, SUM Hospital, Bhubaneswar

is an Assistant Professor in the Department of Microbiology at SUM Hospital, Bhubaneswar. Her research interests include clinical microbiology, emerging infectious diseases, diagnostic microbiology, and antimicrobial resistance.
Khetra Mohan Tudu, Asst.Prof. Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar

is an Assistant Professor in the Department of Medicine with expertise in internal medicine and infectious diseases. His academic interests include tropical infections, critical care medicine, and clinical research.
Prafulla Kumar Bariha, Associate.Prof. Dept. of Medicine, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswa.

is an Associate Professor in the Department of Medicine with extensive experience in medical education and the management of communicable diseases. His research focuses on tropical medicine, metabolic disorders, and evidence-based clinical practice.
Manoj Kumar Mohapatra, Retd. Prof. Dept. of Medicinem, V.S.S. Institute of Medical sciences and Research (VIMSAR), Burla, Odisha, India, 768017, SUM Hospital, Bhubaneswar

is a retired Professor of Medicine with over three decades of experience in clinical medicine, infectious diseases, and medical research. He has authored numerous peer-reviewed publications and has made significant contributions to the understanding and management of tropical infectious diseases, particularly scrub typhus and other acute febrile illnesses.

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