Scrub typhus: as it stands today

ABSTRACT

Scrub typhus is one of the three most common causes of prolonged fever in Southeast Asia and Pacific affecting almost 1 million people annually worldwide out of 1 billion exposed. Scrub typhus is a rickettsial infection caused by Orientia Tsutsugamushi transmitted through bite of Chiggers (larval stage of trombiculid mite). It is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure and death. Deaths are attributable to late presentation, delayed diagnosis, and drug resistance. Scrub typhus, though endemic in India; yet is under reported. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, and B/L chest opacities. Relapse is not uncommon. Presumptive treatment with Doxycycline can be a suitable option in febrile patients from Typhus pockets. Alert physician should keep an eye on deviation from usual presentation to changing spectrum of the disease. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.