• AHUTI PANDYA Department of Microbiology, Kaher Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
  • PREETI MEENA Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
  • KULDEEP JAREDA Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India



Orientia tsutsugamushi, Pyrexia of unknown origin, Rickettsial infection, Scrub typhus, Trombiculid mites


Objective: Rickettsial infections is the most neglected and underdiagnosed tropical diseases in developing countries. The most common rickettsial disease, which is caused by the obligate intracellular gram-negative bacteria Orientia tsutsugamushi, is Scrub Typhus. Scrub typhus can prove to an important diagnosis in pyrexia of unknown origin (PUO) patients and is transmitted by a species of trombiculid mites (“chiggers”). Aim of this study is to find seroprevalence and clinical features of scrub typhus among febrile patients from a tertiary care hospital in North India.

Methods: This study was undertaken for a period of 1 y. All the patients attending the outpatient department or admitted indoors suspected of PUO were included in the study. Serum samples of suspected cases were tested for IgM Scrub typhus.

Results: During the study period, a total of 755 cases were tested for scrub typhus, out of which 223 were positive so, the seroprevlance of Scrub typhus is 29.5%. Out of 223 positive patients, 105 (47%) were males and 118 (53%) were females. Maximum no. of patients was from age group 21 to 40 y of age and maximum number of cases is in autumn season. Most common clinical feature is fever, followed by myalgia, headache, ocular pain, dyspnoea, cough and eschar, respectively.

Conclusion: Scrub typhus is an emerging tropical rickettsial disease in the Indian subcontinent. The present study highlights the importance of screening of PUO cases for Scrub typhus as timely institution of simple empirical treatment can prove to be lifesaving in such cases.


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Tamura A, Ohashi N, Urakami H, Miyamura S. Classification of rickettsia tsutsugamushi in a new genus, orientia gen. nov. as orientia tsutsugamushi comb. Int J Syst Bacteriol. 1995;45(3):589-91. doi: 10.1099/00207713-45-3-589, PMID 8590688.

Brown GW, Robinson DM, Huxsoll DL, Ng TS, Lim KJ. Scrub typhus: a common cause of illness in indigenous populations. Trans R Soc Trop Med Hyg. 1976;70(5-6):444-8. doi: 10.1016/0035-9203(76)90127-9, PMID 402722.

Chakraborty S, Sarma N. Scrub typhus: an emerging threat. Indian J Dermatol. 2017 Sep-Oct;62(5):478-85. doi: 10.4103/ijd.IJD_388_17, PMID 28979009, PMCID PMC5618834.

Bonell A, Lubell Y, Newton PN, Crump JA, Paris DH. Estimating the burden of scrub typhus: a systematic review. PLOS Negl Trop Dis. 2017 Sep 25;11(9):e0005838. doi: 10.1371/journal.pntd.0005838, PMID 28945755, PMCID PMC5634655.

Devasagayam E, Dayanand D, Kundu D, Kamath MS, Kirubakaran R, Varghese GM. The burden of scrub typhus in India: a systematic review. PLOS Negl Trop Dis. 2021 Jul 27;15(7):e0009619. doi: 10.1371/journal.pntd.0009619, PMID 34314437, PMCID PMC8345853.

Taylor AJ, Paris DH, Newton PN. A systematic review of mortality from untreated scrub typhus (Orientia tsutsugamushi). PLOS Negl Trop Dis. 2015;9(8):e0003971. doi: 10.1371/journal.pntd.0003971, PMID 26274584.

Narvencar KP, Rodrigues S, Nevrekar RP, Dias L, Dias A, Vaz M. Scrub typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res. 2012 Dec;136(6):1020-4. PMID 23391799.

Takhar RP, Bunkar ML, Arya S, Mirdha N, Mohd A. Scrub typhus: a prospective, observational study during an outbreak in Rajasthan, India. Natl Med J India. 2017 Apr;30(2):69-72. PMID 28816212.

Sivaprakasam E, Rajan M, Pasupathy U, Ravichandran L. Clinical characteristics and predictors of severity of pediatric scrub typhus in a tertiary level hospital in South India. Arch Pediatr Infect Dis. 2020;8(1). doi: 10.5812/pedinfect.92752.

Seong SY, Choi MS, Kim IS. Orientia tsutsugamushi infection: overview and immune responses. Microbes Infect. 2001;3(1):11-21. doi: 10.1016/s1286-4579(00)01352-6, PMID 11226850.

Brown GW, Saunders JP, Singh S, Huxsoll DL, Shirai A. Single dose doxycycline therapy for scrub typhus. Trans R Soc Trop Med Hyg. 1978;72(4):412-6. doi: 10.1016/0035-9203(78)90138-4, PMID 705848.

Chen CC, Juan CJ, Juan CW, Zeng XC, Huang M. Multi-organ dysfunction caused by scrub typhus initially misinterpreted as acute tonsillitis. J Emerg Crit Care Med. 2007;18:161-6.

Saraswati K, Day NP, Mukaka M, Blacksell SD. Scrub typhus point-of-care testing: a systematic review and meta-analysis. PLOS Negl Trop Dis. 2018;12(3):e0006330. doi: 10.1371/journal.pntd.0006330, PMID 29579046.

Phetsouvanh R, Thojaikong T, Phoumin P, Sibounheuang B, Phommasone K, Chansamouth V. Inter and intra-operator variability in the reading of indirect immunofluorescence assays for the serological diagnosis of scrub typhus and murine typhus. Am J Trop Med Hyg. 2013;88(5):932-6. doi: 10.4269/ajtmh.12-0325, PMID 23478577.

Mittal V, Gupta N, Bhattacharya D, Kumar K, Ichhpujani RL, Singh S. Serological evidence of rickettsial infections in Delhi. Indian J Med Res. 2012;135(4):538-41. PMID 22664504.

Singh S, Patel SS, Sahu C, Ghoshal U. Seroprevalence trends of scrub typhus among the febrile patients of Northern India: a prospective cross-sectional study. J Family Med Prim Care. 2021 Jul;10(7):2552-7. doi: 10.4103/jfmpc.jfmpc_2392_20, PMID 34568135.

Rizvi M, Sultan A, Chowdhry M, Azam M, Khan F, Shukla I. Prevalence of scrub typhus in pyrexia of unknown origin and assessment of interleukin-8, tumor necrosis factor-alpha, and interferon-gamma levels in scrub typhus-positive patients. Indian J Pathol Microbiol. 2018;61(1):76-80. doi: 10.4103/IJPM.IJPM_644_16, PMID 29567888.

Veronica J, Rajakumar PG, Jaishree V, Vikram R. Seroprevalence of scrub typhus and clinical profile of children with scrub typhus presenting to a tertiary care hospital in a rural setting. Indian J Clin Pract. 2019;29(11):1028-33.

Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in the Himalayan region of India. Japan J Infect Dis. 2005;58(4):208-10. doi: 10.7883/yoken.JJID.2005.208, PMID 16116251.

Bithu R, Kanodia V, Maheshwari RK. Possibility of scrub typhus in fever of unknown origin (FUO) cases: an experience from Rajasthan. Indian J Med Microbiol. 2014;32(4):387-90. doi: 10.4103/0255-0857.142241, PMID 25297022.

Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S, Purty S. Outbreak of scrub typhus in pondicherry. J Assoc Physicians India. 2010 Jan;58:24-8. PMID 20649095.

Lamichhane P, Pokhrel KM, Alghalyini B, Zaidi AR, Alshehery MZ, Khanal K. Epidemiology, clinical characteristics, diagnosis, and complications of scrub typhus infection in Nepal: a systematic review. Ann Med Surg (Lond). 2023 Sep 5;85(10):5022-30. doi: 10.1097/MS9.0000000000001259, PMID 37811079.



How to Cite

PANDYA, A., P. MEENA, and K. JAREDA. “SEROPREVALENCE AND CLINICAL FEATURES OF SCRUB TYPHUS AMONG FEBRILE PATIENTS IN A TERTIARY CARE HOSPITAL”. International Journal of Current Pharmaceutical Research, vol. 16, no. 3, May 2024, pp. 85-88, doi:10.22159/ijcpr.2024v16i3.4082.



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