An atypical presentation of scrub typhus

Scrub typhus is caused byOrientia tsutsugamushi, characterised by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system.The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillain-Barre syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhusis limited to case reports mainly. This article shows a case report of neurological manifestations of scrub typhus.

Prevalence and outcome of hyponatremia in patients admitted with COVID-19

Background: Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, and outcome of patients having hyponatremia admitted with COVID-19. Methods: This was a retrospective observational study conducted among admitted adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Srinivas institute of medical sciences and research centre, Mukka, Surathkal.Results: This difference in hyponatremia was statistically significant with regard to age (p<0.001), respiratory rate (p=0.002), SpO2(p=0.029), total counts (p=0.03), CRP (p=0.005), and d-dimer (p=0.015).Conclusions: In patients with COVID-19, age, hypotension, respiratory rate, SpO2, total counts, CRP, and D-Dimer have significant correlation with hyponatremia. Also, patients with COVID-19 and hyponatremia have higher rates of mechanical ventilation and mortality

A study of the course and outcome of COVID-19 patients with acute kidney injury admitted in an intensive care unit

Background:COVID-19 is a disease which predominantly affects the lung resulting in ARDS and respiratory failure. We described the factors associated with the development of AKI (acute kidney injury) and explored the relation of AKI and mortality in patients with severe COVID-19 admitted in intensive care unit of our hospital.Methods:A retrospective observational study was conducted in our hospital during the period of April 2021 to June 2021. 182 patients were selected for the study. Ethical committee approval was obtained. Data was analysed using SPSS 20.0Results:Among the 182 patients, AKI occurred in 99 (54%) patients; 18 (18%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 56%, 22% and 21%, respectively. Upon analysis, TC, CRP, D-dimerwere significantly higher in patients with AKI compared to non-AKI. Of the 99 patients with AKI, urine studies showed 59% as having proteinuria and 22% having haematuria. Independent predictors of severe AKI were male gender and higher serum potassium at admission. In-hospitalized patients’ mortality was 37% among patients with AKI versus 5% among those without AKI. Conclusions:AKI complicated the course of nearly 1 in3 patients hospitalized with COVID-19. Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities which are risk factors for mortality in pa