Clinical Prevalence and Atypical Presentations in Scrub Typhus
Journal Title: Indian Journal of Emergency Medicine - Year 2018, Vol 4, Issue 3
Abstract
Study Objective: We studied and describe the clinical and Para clinical profile, complications and outcome among 17 cases of Scrub typhus diagnosed in The Mission Hospital, Durgapur from March 2017 to April 2018. Methods: This was a cross-sectional study of clinical prevalence and presentations of Scrub Typhus at the Emergency Department at the Mission Hospital, Durgapur. We observed suspected cases presenting with high grade fever and recorded patient demographics, vital signs, pulse oximetry, findings on thorough physical examinations. Clinical features at admission, complications occurring during stay, treatment and outcome were recorded for all cases and descriptive statistics are presented in this study. All treatment decisions were at the discretion of the treating provider who was blinded to study measurements to simulate usual care. At the end of the study, provider and patients were assessed for treatment satisfaction. Results: We observed 17 patients (3 children and 14 adults) from all age groups. The most common clinical features included were high grade fever (100%), headache (47.05%), rash (29.41%), hepatomegaly (23.52%), lymphadenopathy (17.64%), skin hyperemia (11.76%), nausea / vomiting (17.64%), cold and dry cough (17.64%), pain abdomen (17.64%) and An Eschar was found in 41.17% which were the predominant clinical features. Complications noted in the patients were mainly of pulmonary pathology noted in 41.17 % of cases, liver enzymes were elevated in MODS which were seen in 11.76% but none of the patients with MODS died. Overall, Use of empiric treatment was considered to reduce the high mortality observed with the disease and resulted in high patient and provider satisfaction. Conclusion: In this study, diagnosis of scrub typhus largely based on a high index of suspicion and careful clinical, laboratory, and epidemiological evaluation with early diagnosis, identifying the complications and predictors of outcome among the diagnosed cases of scrub typhus which led to better outcome with no mortality [4].
Authors and Affiliations
Sonika Dhillon
Keywords
Related Articles
- EP ID EP553036
- DOI 10.21088/ijem.2395.311X.4318.11
- Views 108
- Downloads 0
Comparative Study of Primary Closure Versus Non-Closure in Dog Bite Wounds
Introduction: Dog bites are common in India accounting to 1-2% of patients presenting to Emergency department. There is long drawn controversy regarding the treatment protocol for dog bites. Several studies have shown co...
An Unusual Presentation of an Unprovoked Pulmonary Embolism; Diagnostic Challenges in the Emergency Department
Pulmonary embolism is a life-threatening condition and in most cases the presentation is typical with h/o pleuritic chest pain, breathlessness and h/o prolonged immobilization. However unusual presentations are not very...
Epidemics of Acute Encephalitis in Young Children: Lychee the Sweet Hypoglycemic or a Silent Killer
Epidemics of acute encephalitis In young children:Lychee the sweet hypoglycemic or a silent killer a review of literature.There have been reports of children presenting with acute neurological illness from Bihar India da...
Partial Empty Sella Syndrome Presenting to Emergency as a Case of Recurrent Hyponatremia: A Rare Presentation
Electrolyte disturbance is a common finding in elderly individuals presenting to emergency with disturbed level of consciousness and hyponatremia is one of the commonest cause associated with lots of other clinical disor...
Integrative Weaning Index: Can it be Used Routinely as a Predictor of Weaning Success?
Objective: Application of Integrative Weaning Index in predicting weaning success. Materials and Methods: A prospective study on the mechanically ventilated 26 patients; after minimum 24 hours of ventilation criterias of...