Clinical and laboratory indicators of severe scrub typhus in adults: Insights from a retrospective study in a teaching hospital in South India.

Abstract

Scrub typhus, caused by <i>Orientia tsutsugamushi</i>, is a mite-borne infectious disease prevalent in the "tsutsugamushi triangle," including India. This study analyzes clinical and laboratory characteristics of scrub typhus patients at a tertiary care hospital in Puducherry to improve timely diagnosis, risk assessment, and management of complications. To identify the clinical and laboratory predictors associated with the severity of scrub typhus in patients admitted to a teaching hospital in Puducherry, South India. A retrospective analysis was conducted on scrub typhus patients aged 18 years and above admitted to Mahatma Gandhi Hospital, Puducherry, from 2019 to 2023. IgM ELISA confirmed diagnosis. Statistical tests identified clinical and laboratory predictors associated with severe disease outcomes. Among 546 scrub typhus cases, 44.1% were males and 55.9% females, with a mean age of 47.1 years. High-grade fever (87.9%) and eschar (44.1%) were the most common symptoms. Significant predictors of severity included diabetes mellitus (<i>P</i> = 0.001; odds ratio [OR] =3.206), skin rash (<i>P</i> = 0.030; OR = 1.888), and hemoglobin <7 g/dL (<i>P</i> = 0.004; OR = 4.407). This study underscores the public health burden of scrub typhus, emphasizing severe complications like myocarditis and pneumonia. Identifying key predictors, such as diabetes, skin rash, and severe anemia, is crucial for early recognition and timely intervention to reduce mortality and manage the disease effectively.