{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:28:41Z","timestamp":1786649321924,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Scrub typhus, caused by\n                      <jats:italic toggle=\"yes\">Orientia tsutsugamushi<\/jats:italic>\n                      , is a mite-borne infectious disease prevalent in the \u201ctsutsugamushi triangle,\u201d 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001; odds ratio [OR] =3.206), skin rash (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030; OR = 1.888), and hemoglobin &lt;7 g\/dL (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004; OR = 4.407).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_802_25","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:00:35Z","timestamp":1776679235000},"page":"1346-1352","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and laboratory indicators of severe scrub typhus in adults: Insights from a retrospective study in a teaching hospital in South India"],"prefix":"10.4103","volume":"15","author":[{"given":"L Lourde","family":"Raja","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Premkumar","family":"Ramasubramani","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Srividya","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research-Vector Control Research Centre, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Senkadhirdasan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Prahankumar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical 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Balakrishna","family":"Pillai","sequence":"additional","affiliation":[{"name":"Department of Clinical Virology, Institute of Advanced Virology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"R1-20260424","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/1471-2334-10-108","article-title":"Clinical and laboratory findings associated with severe scrub typhus","volume":"10","author":"Kim","year":"2010","journal-title":"BMC Infect Dis"},{"key":"R2-20260424","doi-asserted-by":"crossref","first-page":"1371905","DOI":"10.3389\/fitd.2024.1371905","article-title":"Linking the increasing epidemiology of scrub typhus transmission in India and South Asia:Are the varying environment and the reservoir animals the factors behind?","volume":"5","author":"Mohapatra","year":"2024","journal-title":"Front Trop 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therapeutic outcome of scrub typhus in children","volume":"18","author":"Chapagain","year":"2020","journal-title":"J Nepal Health Res Counc"},{"key":"R10-20260424","first-page":"e62867","article-title":"Unravelling the enigma of scrub typhus:A critical review and insights into epidemiology, clinical features, diagnostic advances, and emerging trends","volume":"16","author":"Tarale","year":"2024","journal-title":"Cureus"},{"key":"R11-20260424","doi-asserted-by":"crossref","first-page":"e0009283","DOI":"10.1371\/journal.pntd.0009283","article-title":"High initial IgG antibody levels against Orientia tsutsugamushi are associated with an increased risk of severe scrub typhus infection","volume":"15","author":"Devamani","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"R12-20260424","doi-asserted-by":"crossref","first-page":"e0008747","DOI":"10.1371\/journal.pntd.0008747","article-title":"Performance of molecular and serologic tests for the diagnosis of scrub 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