614. Scrub Typhus: A cause for Pyrexia of Unknown Origin-Scenario in Chennai city, South India.
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Background: Scrub typhus is re-emerging vector borne zoonotic disease in India. It is grossly under diagnosed and its awareness among clinicians is limited. Few reports has been published on the prevalence of scrub typhus in Chennai. The objective of this study was to identify scrub typhus infections in patients with Pyrexia of Unknown Origin (PUO) cases in Chennai, South India.
Methods: This was a prospective study. Patients with fever who presented to the Department of Experimental Medicine at T.N. Dr. M.G.R. Medical University between November 2015 to February 2016 were enrolled. Demographics and clinical symptoms and signs were recorded using a semi structured questionnaire. Under aseptic precautions, 2 ml of blood was collected by venipuncture and serum was separated and stored at 4ºC for further testing. The scrub typhus Detect ELISA test was performed to detect IgM antibodies against Orientia tsutsugamushi. Data was analysed using mean and percentages.
Results: A total of 100 patients were enrolled and their age ranged from 4 to 80 years with a mean of 30 years (SD 21). Fifty six percent were males and 44% were females. Twenty three percent (23/100) were positive for IgM antibodies against O. Tsutsugamushi. Most (65%) of the positive patients were females. Majority of the patients (48%) positive for scrub typhus were in the younger age group (4-20 years) followed by patients in the age group 20-30 and 40-50 years with 17% in each group. About 65% had myalgia and 61% of patients suffered headache, nausea and cough. Nearly 48% developed vomitting and abdominal pain. Infrequent complaints were breathlessness, diarrhoea, jaundice, altered sensorium and rashes. The pathognomonic feature such as eschar was seen only in 3 patients. Five patients were also positive for Salmonella typhi.
Conclusion: In the present study 23% of patients were positive for scrub typhus infection. Hence scrub typhus infection should be considered as differential diagnosis in PUO cases in Chennai city.
S Mini Jacob, M.D1, S Geethalakshmi, M.D., Ph.D2, S. Jasmine Abinaya Mary, MSc3, K Sivasangeetha, M.D.1, G Pachiyappan, B.Sc1, G Thatchinamoorthy, MSc1 and P Gowthami, BSc1, (1)Department of Experimental Medicine, The Tamilnadu Dr MGR Medical University, Chennai, India, (2)The Tamilnadu Dr MGR Medical University, Chennai, India, (3)Bharathidasan University, Trichy, India
S. Mini Jacob,
None S. J. Abinaya Mary,
None K. Sivasangeetha,
None G. Pachiyappan,
None G. Thatchinamoorthy,
None P. Gowthami,