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Clinical and biochemical profile of scrub typhus patients at a tertiary care hospital in Northern India.

BACKGROUND: Scrub typhus is a neglected rickettsial disease in India. Every year, we are facing outbreaks of Scrub typhus after Monsoon season. Patients present with a wide clinical spectrum ranging from pyrexia of unknown origin to multiple organ dysfunction. Some of these clinical features overlap with presentation of other tropical infections prevalent in Indian subcontinent, which leads to diagnostic dilemma and delay in diagnosis. Hence, we planned this study to know the demographic, clinical and biochemical profile of scrub typhus patients. METHODS: This was an observational study condu…

Assessing scrub typhus and rickettsioses transmission risks in the Chiang Rai province of northern Thailand.

BACKGROUND: Scrub typhus is an important disease in the Asia-Pacific countries with increasing relevance for public health worldwide. Entomological risk assessment for scrub typhus and rickettsial disease in Phu Chi Fah village-Chiang Rai was performed to determine areas at greatest risk for disease transmission in order to increase awareness of diseases to travelers and healthcare workers. METHODS: From 2016 to 2018, rodents and chiggers were collected from 7 sites covering residential, grassland, and forest areas to determine the prevalence of pathogen of interest. The correlation between l…

Analysis of the epidemiological and clinical characteristics of 65 patients with scrub typhus on the east coast of China.

BACKGROUND: The present study set out to investigate the epidemiological and clinical characteristics of 65 patients with tsutsugamushi disease. METHODS: The clinical data of 65 patients with tsutsugamushi disease, who were admitted to the Affiliated Hospital of Nantong University were retrospectively analyzed. The clinical symptoms, laboratory examination results, clinical treatment plans, treatments, and outcomes of the patients were analyzed. RESULTS: The 65 patients with tsutsugamushi disease, included 40 males (61.54%) and 25 females (38.46%). The patients were aged from 1 year and 7 mo

Epidemiology and Risk Factors for Notifiable Scrub Typhus in Taiwan during the Period 2010-2019.

Scrub typhus is a zoonotic disease caused by the bacterium Orientia tsutsugamushi. In this study, the epidemiological characteristics of scrub typhus in Taiwan, including gender, age, seasonal variation, climate factors, and epidemic trends from 2010 to 2019 were investigated. Information about scrub typhus in Taiwan was extracted from annual summary data made publicly available on the internet by the Taiwan Centers for Disease Control. From 2010 to 2019, there were 4352 confirmed domestic and 22 imported cases of scrub typhus. The incidence of scrub typhus ranged from 1.39 to 2.30 per 100,000…

Determination of cut-off of diagnostic ELISA for Scrub typhus in endemic setup: Central India.

Serology remains the mainstay for diagnosis of scrub typhus. In central India, diagnosis of this neglected emerging zoonotic disease suffers due to lack of standardized region-specific cutoff value and diagnostic test. Henceforth, standardized region-specific cutoff value for diagnostic ELISA play a significant role in initial treatment of patients and to differentiate other febrile diseases in endemic setup. A total of 144 patients of all age groups with acute undifferentiated febrile illness patients, forty healthy controls, dengue and chikungunya positive thirty-five samples in each categor…

The scrub typhus in mainland China: spatiotemporal expansion and risk prediction underpinned by complex factors.

In mainland China, a geographic northward expansion of scrub typhus has been seen, highlighting the need to understand the factors and identify the risk for disease prevention. Incidence data from 1980 to 2013 were used. A Cox proportional hazard model was used to identify drivers for spatial spread, and a boosted regression tree (BRT) model was constructed to predict potential risk areas. Since the 1980s, an invasive expansion from South Natural Foci towards North Natural Foci was clearly identified, with the epidemiological heterogeneity observed between two regions, mainly in spatial distri…

Assessment of two immunoassays for detection of IgM antibodies to scrub typhus using a serum panel.

Laboratory tests are necessary for diagnosis of scrub typhus (ST) especially in the absence of the distinctive eschar. Performance of an ELISA and ICT (immunochromatography) to detect IgM antibodies to scrub typhus was assessed using a panel of 346 sera chosen from healthy individuals, those with scrub typhus and scrub-typhus like illness. A sensitivity of 98.7% for ST IgM ICT and 97.4% for ST IgM ELISA was observed while specificity was 96.3% for ICT and 95.9% for ELISA. As excellent concordance (98.8%) was noted between the two assays, IgM ICT can be used for rapid diagnosis of scrub typhus.…

Spectrum of cardiac manifestations and its relationship to outcomes in patients admitted with scrub typhus infection.

AIM: To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes. METHODS: Demographic data, electrocardiographic (ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio (OR) with 95%CI. RESULTS: The cohort …

Factors for Severe Outcome in Scrub Typhus: A Hospital Based Study in Sub Himalayan Region.

BACKGROUND: Scrub typhus is a re-emerging zoonotic rickettsial infection. Mortality is approximately 15% in some areas due to missed or delayed diagnosis. There had been only few studies on the markers for the severity of the disease, so this study has been planned to provide the knowledge regarding various aspects of scrub typhus in adult age group to detect early signs of severity . METHODS: All the patients more than 18 years of age admitted with febrile illness with positive IgM ELISA for scrub typhus with or without eschar were included in the study. The clinical profile was observed. Th…

Clinical significance of NGAL and KIM-1 for acute kidney injury in patients with scrub typhus.

BACKGROUND: The aim of this study is to investigate the clinical significance of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) for acute kidney injury (AKI) in patients with scrub typhus. METHODS: From 2014 to 2015, 145 patients were diagnosed with scrub typhus. Of these, we enrolled 138 patients who were followed up until renal recovery or for at least 3 months. We measured serum and urine NGAL and KIM-1 levels and evaluated prognostic factors affecting scrub typhus-associated AKI. RESULTS: Of the 138 patients, 25 had scrub typhus-associated AKI. The…

Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016.

Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. We established surveillance for acute febrile illness (AFI) (fever ≥ 4 days duration) in peripheral health facilities in Gorakhpur district to understand the relative contribution of scrub typhus. Of the 224 patients enrolled during the 3-month period corresponding to the peak of AES cases in the …

ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE.

Scrub typhus rarely presents with acute cholecystitis. We present 2 cases of scrub typhus with cholecystitis. The first patient is a 62 year old female who presented to the hospital with fever and body aches for 1 week and right upper quadrant abdominal pain for 3 days. She gave a history of an insect bite 2 weeks previously. She was diagnosed as having acute cholecystitis and underwent cholecystectomy. She continued with fever post-operatively and physical examination revealed an eschar. She had an immunofluorescence assay (IFA) performed that revealed a high IgM titer for Orientia tsutsugamu…

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India.

BACKGROUND: India is an integral component of "tsutsugamushi triangle" which depicts a part of the globe endemic to scrub typhus. Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is described as a re-emerging infectious disease in India. The present study aimed to study the clinical and paraclinical profile, complications and predictors of outcome among 90 cases of scrub typhus diagnosed in a hospital of north-eastern India from Sept 2011 to Aug 2012. METHODS: A longitudinal study was conducted in a hospital of Meghalaya, India between S…

Scrub typhus-an emerging entity: a study from a tertiary care hospital in North India.

Scrub typhus is a tropical febrile zoonotic disease caused by Orientia tsutsugamushi of the rickettsial family. These are obligate; intracellular Gram-negative coccobacilli transmitted by the bite of infected mites. It is usually under-diagnosed in India due to its varied and nonspecific clinical presentation, limited awareness, and low index of suspicion among clinicians and lack of diagnostic facilities. This study was planned to monitor the level of scrub typhus-specific antibodies among febrile patients in a tertiary care hospital over a period of 1 year for which a rapid qualitative immun…

The clinical differences between dengue and scrub typhus with acute respiratory failure in southern Taiwan.

BACKGROUND: For both dengue and scrub typhus, acute respiratory failure (ARF) is a serious complication. The present study was carried out in order to investigate the clinical courses and outcomes of adult dengue and scrub typhus patients with ARF, and to identify the clinical differences between adult dengue and scrub typhus patients with ARF. METHODS: We conducted a retrospective study of the serologically confirmed adult dengue or scrub typhus patients admitted between 1998 and 2008 at Kaohsiung Chang Gung Memorial Hospital. A total of 980 dengue and 102 scrub typhus adult patients were in…

Orientia tsutsugamushi, the causative agent of scrub typhus, induces an inflammatory program in human macrophages.

Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, a bacterium that primarily infects endothelial cells both in vitro and in vivo. Evidence suggests that the interaction of O. tsutsugamushi with myeloid cells may play a pivotal role in O. tsutsugamushi infection. We demonstrated that O. tsutsugamushi replicated within human monocyte-derived macrophages. Bacteria stimulated the expression of a large number of genes, including type I interferon genes, interferon-stimulated genes, inflammation-associated genes and apoptosis-related genes, and the release of inflammatory …

Surveillance of Scrub Typhus in the fringe areas around Pune : Potential for Transmission does exist.

A field based epidemiological study was undertaken to assess the potential of transmission of scrub typhus in the sylvatic and transitional (fringe) areas at ten different locations around Pune. Parameters studied included rodent trapping and identification, entomological parameters, immunological studies on rodent sera, and rodent organ impression smears. The study revealed that Rattus r rufescence, Rattus meltada, Suncus murinus and Rattus blanfordi were the predominant sylvatic rodent species. All the species showed mild to moderate infestation with trombiculid mite larvae, with Rr rufescen…

Пространственный анализ скруба тифа и его связи с экологическими и социально-экономическими факторами на Тайване.

Мы проанализировали пространственное распределение человеческих случаев скруба тифа на главном острове Тайвань в период с 2003 по 2008 год и провели в масштабах всего острова обследование переносчиков скруба тифа (тромбикулидов) в 2007 и 2008 годах. Стандартизованный коэффициент заболеваемости "SIR" с учетом межрайонных различий населения, пола и возраста коррелировал с экологическими и социально-экономическими переменными. Более высокие показатели заболеваемости и SIR были сгруппированы в менее развитых горных районах центрального и восточного Тайваня. Более высокие СИР также связаны с более

Совпадение в аннотации оригинала
We analyzed the spatial distribution of human cases of scrub typhus on the main island of Taiwan from 2003 to 2008 and implemented an island-wide survey of scrub typhus vectors (trombiculid chiggers) in 2007 and 2008. The standardized incidence rate 'SIR' incorporating inter-district variations in population, gender and age was correlated with environmental …