Scrub Typhus as a Cause of Acute Undifferentiated Febrile Illness: A Retrospective Observational Study of Clinical Spectrum and Outcomes

Omprakash Karbhari  Solanke; Ranjana Deshmukh

Omprakash Karbhari Solanke Junior Resident, DNB General Medicine, MD Medicine, Department of Medicine, Dr. Hedgewar Rugnalaya, Chhatrapati Sambhajinagar, Maharashtra, India
Ranjana Deshmukh Head of Department, MD Medicine, Department of Medicine, Dr. Hedgewar Rugnalaya, Chhatrapati Sambhajinagar, Maharashtra, India

Keywords: Scrub Typhus, ARDS, Chigger mites, Thrombocytopenia, IgM ELISA, Acute febrile illness, Eschar, Myalgia

Abstract

Background: Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging cause of acute febrile illness across the Indian subcontinent. Transmission peaks during monsoon and post-monsoon seasons due to increased chigger mite activity in humid environments, with rodents serving as natural reservoirs. Nonspecific clinical manifestations and limited diagnostic markers contribute to frequent diagnostic delays.

Materials and Methods: This retrospective observational study was conducted in the Department of Medicine of a tertiary care hospital over three months. Patients with laboratory-confirmed scrub typhus were included. Demographic characteristics, clinical features, treatment practices, and outcomes were analyzed descriptively. Continuous variables were summarized as mean plus minus standard deviation (SD), and categorical variables as frequencies and percentages.

Results: Thirty patients were included. Females constituted 60% of cases, and males 40%. The mean age was 48.6 plus minus 18 years, indicating predominant involvement of middle-aged adults. Scrub typhus presents as an acute, undifferentiated febrile illness with variable clinical manifestations. Combination antimicrobial therapy was used in severe cases.

Conclusion: Scrub typhus remains an important cause of acute febrile illness in endemic regions. Early recognition based on clinical features, supportive laboratory findings, and epidemiological context—rather than reliance on eschar alone—is critical. The patients who received prompt antimicrobial therapy did well, reinforcing that early treatment prevents progression to severe disease. Maintaining a high index of suspicion, particularly during the monsoon and post-monsoon months, remains key to reducing morbidity and mortality from scrub typhus in endemic settings like this one.

DOI: https://doi.org/10.24321/0019.5138.202670

How to cite this article:
Deshmukh R G, Solanke O K. Scrub Typhus as a Cause of Acute Undifferentiated Febrile Illness:
A Retrospective Observational Study of Clin ical Spectrum and Outcomes. J Commun Dis.
2026;58(3):266-230.

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