A study on demographic, clinical profile, and outcome of scrub typhus

Background: Scrub typhus, caused by Orientia tsutsugamushi, is an emerging zoonotic infection transmitted through chigger mite bites. It presents with non-specific symptoms and mimics other febrile illnesses, often leading to diagnostic delays and serious complications. Aims and Objectives: This study analyzed the demographic, clinical, and laboratory features of patients with scrub typhus and assessed the outcomes based on disease severity. Materials and Methods: This prospective observational study was conducted at Dharmapuri Medical College and Hospital in Tamil Nadu. A total of 160 patients who were clinically diagnosed with scrub typhus were included. Demographic details, clinical presentations, laboratory parameters, and outcomes were also recorded. Patients were stratified into three categories based on disease severity: Non-severe, severe, and very severe/fatal. Results: Most patients were aged 20–60 years (80%), with a mean age of 40.83±13.79 and 38.77±2.90 years in males and females, respectively. Most cases were from rural areas (80% males and 82.7% females). Fever was present in 100% of cases, followed by vomiting (31.25%), myalgia (30%), abdominal pain (20%), and headaches (19.37%). Eschar was noted in only 6 patients (3.75%). Laboratory abnormalities included hypoalbuminemia (70%), elevated liver enzyme levels (68.75%), and thrombocytopenia (67.5%). Other clinical findings included severe thrombocytopenia (5%), elevated serum triglycerides (50%), and elevated lactate dehydrogenase (43.75%). Complications included electrolyte disturbances (30%), acute renal failure (18.75%), acute respiratory distress syndrome (13.75%), and multi-organ dysfunction syndrome (13.75%). Delayed presentation and very severe disease conditions led to mortality (3.75%). Conclusion: Scrub typhus continues to pose a diagnostic challenge because of its varied presentations. Early identification based on clinical suspicion, key laboratory markers, and categorization of disease severity can greatly reduce complications and improve patient outcomes.