Predictors of scrub typhus: a study from a tertiary care center

ObjectiveTo document the clinical and laboratory findings of scrub typhus infection and to determine the prognostic factors of the disease.MethodsRetrospective data were collected from 96 patients with scrub typhus infection, from January 2012 to December 2013, at Yashoda hospital, Hyderabad. Prognostic factors for severe scrub typhus were analyzed by a multivariate analysis.ResultsOut of 96 patients, men were 47 (48.9%) and median age was 39 years. Patients with low socioeconomic status were 53 (55.3%). Among the 96 patients 46 (47.9%) had severe scrub typhus, 50 (52.1%) had mild severe scrub typhus. Two patients (2%) died. Symptoms of cough (P=0.001), presence of eschar (P<0.001), Glasgow coma scale (GCS) below 12 (0.04), hepatomegaly (P=0.0001), splenomegaly (P=0.000 1), and meningoencephalitis (P=0.01), were significantly associated with severe scrub typhus. Multivariate analysis showed presence of eschar (odds 2.5; 95% confidence interval (CI) 1.1–8.5), hepatomegaly (odds 1.9; 95% CI 1.1–3.8), meningoencephalitis (odds 4.8; 95% CI 1.1–21.8), GCS<12 (odds 1.8; 95% CI 0.5–2.4) and cough (odds 1.5; 95% CI 0.7–3.5) to be significantly associated with severe scrub typhus.ConclusionsIn our study, eschar, hepatomegaly, meningoencephalitis, poor GCS and cough were significantly associated with severe scrub typhus.