Scrub Typhus – Changing Trends and Varying Symptomatology

Background: Cases of scrub typhus are reported in increasing numbers in various parts of Kerala. The varying symptomatology and clinical presentations and complications have made the diagnosis difficult without laboratory support. Aim : This descriptive study attempts to analyse the symptomatology and complications in patients admitted with Scrub typhus during2015and 2016 and to estimate the seroprevalence of Scrub typhus in the hospital during this period. Methods: Forty inpatients who were tested positive for Scrub typhus IgM ELISA were included in the study. The clinical records were examined in detail for symptoms, signs and complications. The serum samples were also subjected to Weil felix test. Seroprevalence was estimated from laboratory records. Results: Fever (100%) and myalgia(42.5% ) were the common symptoms but rare symptoms like bleeding manifestations, jaundice and loose stools were seen in 10% each. Eschar was present in 20% patients .Complications like acute kidney injury(15%),myocarditis (5%)and ARDS (2.5%) were found .Nineteen patients gave a positive Weil felix test ie. (47.5%). Conclusion: Scrub typhus is occurring with increasing prevalence and varying clinical presentations .Weil Felix test can still be employed in resource poor settings like primary health care facilities where even ELISA is not feasible.