Scrub Typhus--A Re-Emerging Infection.

chills and rigors, headache, vomiting, cough which are all non-specific. Out of all the patients with pyrexia of intermediate duration studied, 10 had hepatosplenomegaly and only 1 scrub typhus positive patient had the sign and 1 out of the total 92 patients had neck stiffness and he was positive for scrub typhus by PCR. None of them had an eschar which is supposed to be characteristic of rickettsial fever. The laboratory abnormalities noted among the positive patients included elevated SGOT/SGPT levels, (7 out of 8 patients) and half the number of positive patients (4 out of 8) showed presence of urine micro albuminuria. These findings are very similar to many of the studies done in the recent past by M Vivekanandan et al1 from Pondicherry, Narvencar KPS et al2 from Goa and the study by MVS Subbalaxmi et al.3 S c r u b t y p h u s a c c o u n t s f o r nearly 20% of all cases of pyrexia o f i n t e r m e d i a t e d u r a t i o n i n endemic areas. Typhus is rarely diagnosed as a cause of pyrexia of intermediate duration and the public health importance of this disease is underestimated due to lack of diagnostic facilities and a low index of suspicion among health care workers due to the non specific nature of the c l inical s igns and symptoms. PCR typhus is a rapid and specific test for quick diagnosis of scrub typhus. Moreover definitive treatment of this group of illnesses is relatively simple involving the use of single drug therapy with universally available drugs like Doxycycline, Chloramphenicol, Roxithromycin, Azithromycin. Scrub Typhus – A Re-Emerging Infection