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What is scrub typhus infection? How does this affect humans and how to treat this?

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What is Scrub Thypus infection? How does this affect humans? How XXXXXXX is it? How to treat this properly?

One of my close relative is undergoing treatment for past one and half week in hospital with severe pains.

The early symptoms started with fever, then three days later the platelets gone down till 0000. Later he suffered with severe stomach pain. In first week he also suffered with motions and varmitings along with headache. Early second week, he looks normal with mild fever. Suddenly yesterday, the BP gone upto 220/90. After sometime he was in unconcious for almost 3 hours, not responding to any commands, no sense in any part of the body. Suddenly he came out of trans after 3 hours and talking normally and full control of the body. Later some time, the BP went down to 110/60 and now stable at 110/70.

Yesterday late evening the doctors conirmed that he is suffering from "Scrub thypus infection". Please check the attachment for the report. I am not sure whether they have started related medicines. Currently he is in Accute medical care unit of NIMS,hyderbad in full observation.

As of now, he looks normal, but we are really worried with the way it is happening.

Could you please help us understanding this deacese and severity? If possible, please outline the general treatment followed by the doctors? I will take your suggestions only for crosscheck and will not use for any purpose.

I understand, this information is not sufficient for understanding the case.
Posted Thu, 30 Aug 2012 in Infections
Answered by Dr. Rajiv K Khandelwal 41 minutes later

Thanks for your query.

Scrub typhus is caused by an intracellular parasite, Orientia tsutsugamushi, belonging to the family Rickettsiaceae. Trombiculid mites transmit it. The bite by this mite leaves a characteristic black eschar at the site.

The symptoms are as you have described in your close relative and has been confirmed by the serology report which you enclosed. Other methods of confirmation include culture and PCR test but they are not available routinely.

If not treated with antibiotics the disease is often fatal. However, the case fatalities have decreased from 4-40% to less than 2% with proper treatment.

The antibiotic of choice is doxycycline with chloramphenicol as an alternative. Resistant strains to doxy and chloramphenicol have been reported in which case rifampicin and azithromycin are used.

No vaccine is currently available.

Coming to the treatment of your relative, from your description it appears that he developed complication in the form of myocarditis and with good supportive treatment; he should be on the road to recovery. I suggest that you freely discuss with the treating doctors in the Nizam Institute who must be taking all the necessary care in the case of your relative.

I hope I have enlightened you on this disease and wish your relative a speedy recovery.

Do write back in case you have more queries to ask.

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