ABSTRACT
Scrub typhus is a form of bacterial Zoonosis caused by Orintia tsutsugamushi usually presents as Acute febrile illness with multiorgan involvement as a complication and is associated with significant mortality. This study aims to document the clinico-demographic profile, laboratory parameters and complication of Scrub Typhus in North Eastern Hilly State of Tripura with background of tropical climate. This retrospective study was conducted at Tripura Medical College, including 42 patients admitted with acute febrile illness between June, 2020 to December, 2021 during the era of COVID-19 Pandemic. The diagnosis was established by Rapid card test, Lateral Flow Metry Assay (LFA) followed by confirmation through IgM, ELISA test and pathognomic Eschar where feasible. The clinlical, demographic and laboratory profile were documented and analysed. Post rainy season and people from rural area with farming background were mostly affected population. Apart from Fever and Flu like symptom, respiratory and Gastrointestinal (GI) symptoms were more prominent feature. Pathognomic skin lesion eschar was found in maximum cases followed by shortness of breath, GI involvement and Renal failure. Acute Respiratory Distress Syndrome (ARDS), Acute Kidney Injury (AKI), Hepatic encephalopathy and meningitis were the serious complications. While evaluating cases of acute febrile illness with multiorgan involvement clinician should have high index of suspicion for Scrub typhus specially resource poor areas of North Eastern (NE) state of India so that early detection and time bound intervention may help to reduce the mortality
ABSTRACT
Bacterial co-infection associated with malaria is potentially important but poorly documented. Published reports are mainly from African children while data from adult Indian population are limited. To determine the spectrum of concurrent bacterial infection in malaria the present study was conducted in department of Medicine at Tripura Medical College. Out of eighty patients, 58 had falciparum, 15 had dual infection and 7 had vivax malaria. Blood culture failed to confirm bacteraemia in any sample with the exception of one case of complicated malaria showing the growth of Escherichia Coli. Urine culture also grew Escherichia Coli in 2.5% of enrolled patients. Anti salmonella IgM antibody was detected in 7.5% of the study population. Sputum culture was positive of streptococcus pneumoniae in single patient with radiological evidence of consolidation. CSF culture was sterile in cases with cerebral malaria. Thus the present study shows that bacteraemia is uncommon in adults with malaria compared to children of endemic areas. Presence of other co-existent infections should be sought in clinically suspected cases only. We propose a restrictive antibiotic policy in the setting of malaria.