A Study on Clinical Profile, Inflammatory Markers and Outcome of Scrub Typhus

Abstract

Background: Scrub typhus is an important re-emerging zoonotic infection and a significant cause of acute febrile illness in India. Delayed diagnosis may result in severe complications, multiorgan dysfunction, and mortality. This study aimed to describe the clinical profile of scrub typhus and evaluate inflammatory markers, prognosis, and outcomes among affected patients.

Methods: A hospital-based prospective observational study was conducted in the Department of General Medicine and Acute Medical Intensive Care Unit at PES Institute of Medical Sciences and Research, Kuppam, from May 2024 to October 2025. Sixty-four adult patients with IgM-positive scrub typhus were enrolled. Demographic characteristics, clinical features, laboratory parameters, inflammatory markers, complications, and outcomes were recorded and analyzed using descriptive statistics.

Results: The mean age of patients was 48 ± 15.1 years, with a predominance of females (78.1%). Fever was the most common presenting symptom (98.4%), followed by cough (51.6%) and breathlessness (26.6%). Eschar was identified in only 6.7% of patients. Elevated inflammatory markers were common, including CRP (73.4%), ESR (53.1%), and procalcitonin levels suggestive of sepsis or septic shock in 28.1% of cases. Hepatic dysfunction was frequently observed, with elevated AST (73.4%), prolonged prothrombin time (73.4%), and hypoalbuminemia (64.1%). Hyponatremia occurred in 53.1% of patients. Major complications included myocarditis (32.8%), liver failure (29.6%), renal failure (29.6%), encephalopathy (23.4%), and pulmonary embolism (21.8%). Elevated inflammatory markers and hypoalbuminemia were significantly associated with mortality. The case fatality rate was 6.25%, while 93.75% of patients recovered and were discharged.

Conclusions: Scrub typhus commonly presents with fever and respiratory manifestations and is frequently associated with elevated inflammatory markers and multiorgan involvement. Early diagnosis, close monitoring of inflammatory markers, and prompt treatment are essential for improving outcomes and reducing mortality.