Eschar in Scrub Typhus: A Study from North East India.

INTRODUCTION

Eschar is one of the most important clinical sign which helps in early diagnosis, and consequently initiation of specific treatment and prevention of complications in scrub typhus.

AIMS: To study the prevalence and distribution of eschar in scrub typhus and comparison of clinical manifestations and complications among patients with or without eschar.

METHODOLOGY: A retrospective hospital based study in patients aged ≥ 18 years admitted to a tertiary care centre in north-eastern India. Scrub typhus was diagnosed based on clinical features supported by serological tests (Immunochromatographic card test, IgM ELISA and Weil Felix test). Chi square test was used for comparing variables. A 'p value' <0.05 was considered as statistically significant.

RESULTS

A total of 129 patients of scrub typhus were included in the present study. Male to female ratio is 1.93:1 with the commonest age group being 18-30 years followed by 30-40 years. Eschar was found in 24.8% patients with 9.3% having multiple eschars and the rest had single eschar. Eschar was most commonly found in the inguinal region (28.57%) followed by trunk (25.75%) and lower limbs (22.85%). Presence of multi-organ dysfunction (p=0.008), hepatitis (p=0.005) and lymphadenopathy (p<0.01) were significantly higher in those patients who had eschar.

CONCLUSION

The common sites of distribution of eschar are the inguinal region, lower limbs and trunk and multiorgan dysfunction is more commonly associated with eschars.