From Febrile Illness To Multiorgan Dysfunction: Expanding The Clinical, Biochemical And Epidemiological Spectrum Of Scrub Typhus — A 12-Month Retrospective Study
Abstract
Background: Scrub typhus is caused by Orientia tsutsugamushi and transmitted to humans through the bite of infected larval trombiculid mites (chiggers). It is an underdiagnosed cause of acute febrile illness in India, as it presents with nonspecific manifestations and resembles other tropical infections. If not recognised early, scrub typhus can progress to severe complications, including multiorgan dysfunction and death.
Objectives: To evaluate the demographic profile, clinical manifestations, biochemical abnormalities, complications and outcome of patients suffering from scrub typhus in a tertiary care hospital.
Methods: The study was carried out in the Department of Microbiology, Saveetha Medical College, Chennai, from January to December 2025. Patients of all ages presenting with acute febrile illness and positive for
scrub typhus by IgM ELISA were enrolled in the study. Serum samples were subjected to IgM ELISA using the Scrub Typhus DetectTM IgM ELISA Kit (InBios).
Results: Of 2566 samples, 193 (7.5%) were positive. Males accounted for 52% and females 48%. Most cases were aged 41–60 years (35%) with a statistically significant difference across age groups (Chi-square
test, p < 0.0001). Seasonal peaks were observed in December (17%) and January (15%). Fever was predominant (94.8%), followed by cough (32.6%), chills and rigour (30.6%), vomiting (28%), myalgia (24.9%), abdominal pain (23.3%) and headache (22.8%). Eschar was observed in 7.3%. Laboratory abnormalities included liver dysfunction (78%), electrolyte imbalance (60%), thrombocytopenia (35%) and renal dysfunction (24.4%). Comorbidities were present in 34%, mainly diabetes and hypertension. Complications included ARDS (9%), septic shock (7%) and AKI (3%). Mortality was 2.6%, and 97.4% recovered after treatment.
Conclusion: Scrub typhus remains an important cause of acute febrile illness in endemic areas. Early diagnosis
enables timely treatment and reduces complications and mortality.
Keywords: ELISA –Enzyme Linked Immunosorbent Assay; ARDS – Acute Respiratory Distress Syndrome; AKI – Acute Kidney Injur
DOI: https://doi.org/10.24321/0019.5138.202628
How to cite this article:
Praveetha C. From Febrile Illness To Multiorgan Dysfunction: Expanding The Clinical, Biochemical
And Epidemiological Spectrum Of Scrub Typhus — A 12-Month Retrospective Study. J Commun Dis. 2026;58(2):47-54.
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