Prevalence of scrub typhus in a tertiary care centre in Telangana, south India

  • Ram Mohan Mylavarapu Venkata Naga Lakshmi Department of Microbiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Teja Vijay Dharma Department of Microbiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Sukanya Sudhaharan Department of Microbiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Subbalaxmi Malladi Venkata Surya Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Rajkiran Emmadi Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Satyanarayana Raju Yadati Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Nageswara Rao Modugu Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
  • Aparna Jyotsna Department of Microbiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
Keywords:
Scrub typhus; Immunochromatographic test; Acute undifferentiated fever; Enzyme linked immunosorbent assay

Abstract

Background and Objectives: Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the “gold standard” immunofluorescent assay and the unreliable nature of Weil Felix test often results in delayed or misdiagnosis in a majority of cases. The present study seeks to integrate the results of rapid diagnostic tests, clinical and laboratory features to aid the diagnosis and management of scrub typhus patients.
Materials and Methods: A total of 645 serum samples with suspected scrub typhus sent to the Department of Microbiology were included in the study. Scrub typhus was tested by rapid immunochromatographic test (SD Diagnostics) and IgM ELISA (Inbios International, USA). Clinical features, laboratory parameters and final outcome were analysed from the clinical records of positive patients.
Results: Scrub typhus was diagnosed in 13.7% of patients and majority of them were observed in the month of August. 58.6% of scrub typhus patients presented with fever of one to two weeks duration. Eschar was documented in 13.7% of patients and 24% of patients gave a history of working outdoors or exposure to vegetation. All the patients responded to Doxycycline treatment and there was no mortality.
Conclusion: High index of suspicion for scrub typhus is necessary in febrile patients not responding to conventional antibiotics especially during outbreak situations. Rapid immunochromatographic tests with excellent specificity and acceptable sensitivity can be used as potential point of care tests for quick diagnosis of scrub typhus especially in delayed presentation.

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Published
2020-05-29
How to Cite
1.
Mylavarapu Venkata Naga Lakshmi RM, Vijay Dharma T, Sudhaharan S, Malladi Venkata Surya S, Emmadi R, Raju Yadati S, Rao Modugu N, Jyotsna A. Prevalence of scrub typhus in a tertiary care centre in Telangana, south India. Iran J Microbiol. 12(3):204-208.
Section
Original Article(s)