{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:56:36Z","timestamp":1788371796356,"version":"build-2803163510"},"reference-count":35,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,3]]},"abstract":"<jats:p>Scrub typhus, a zoonotic disease caused by the bacterium <jats:italic>Orientia tsutsugamushi<\/jats:italic>, has become endemic in many parts of India. We studied the clinical profile of this infection in 228 patients that reported to this tertiary care center from July 2013 to December 2014. The median age of patients was 35 years (interquartile range = 24.5\u201348.5 years), and 111 were males and 117 females. A high-grade fever occurred in 85%, breathlessness in 42%, jaundice in 32%, abdominal pain in 28%, renal failure in 11%, diarrhea in 10%, rashes in 9%, and seizures in 7%. Common laboratory abnormalities at presentation were a deranged hepatic function in 61%, anemia in 54%, leukopenia in 15%, and thrombocytopenia in 90% of our patients. Acute kidney injury (32%), acute respiratory distress syndrome (ARDS) (25%), and disseminated intravascular coagulation (DIC) (16%) were the commonest complications. A hepatorenal syndrome was seen in 38% and multiple organ dysfunction syndrome (MODS) in 20% patients. The overall case fatality rate was 13.6%. In univariate analysis, ARDS requiring mechanical ventilation, acute kidney injury requiring hemodialysis, hypotension requiring inotropic support, central nervous system dysfunction at presentation, and MODS were inversely associated with survival. Survival was significantly higher in patients that presented with a duration of fever &lt; 10 days compared with those that presented \u2265 12 days (<jats:italic>P<\/jats:italic> &lt; 0.05) after onset. In conclusion, scrub typhus has become a leading infectious disease in north India and an important cause of infectious fever. An increasing awareness of this disease coupled with prompt management will go a long way in reducing both morbidity and mortality from this disease.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0086","type":"journal-article","created":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T03:05:34Z","timestamp":1465873534000},"page":"447-451","source":"Crossref","is-referenced-by-count":74,"title":["Scrub Typhus in a Tertiary Care Hospital in North India"],"prefix":"10.4269","volume":"95","author":[{"given":"Navneet","family":"Sharma","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Biswal","sequence":"additional","affiliation":[{"name":"2Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Kumar","sequence":"additional","affiliation":[{"name":"2Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Zaman","sequence":"additional","affiliation":[{"name":"2Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Jain","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Bhalla","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Trop Doct","first-page":"230","article-title":"Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors\u2014an experience from a tertiary care hospital in south India","volume":"40","author":"Chrispal","year":"2010"},{"key":"ref2","series-title":"Clin Microbiol Rev","first-page":"719","article-title":"Tick-borne rickettsioses around the world: emerging diseases challenging old concepts","volume":"18","author":"Parola","year":"2005"},{"issue":"(Suppl 3)","key":"ref3","series-title":"Clin Infect Dis","first-page":"S203","article-title":"Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi","volume":"48","author":"Kelly","year":"2009"},{"key":"ref4","series-title":"Am J Trop Med Hyg","first-page":"301","article-title":"Unresolved problems related to scrub 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prospective observational study","volume":"17","author":"Krishnamurthy","year":"2013"},{"key":"ref35","series-title":"J Infect","first-page":"56","article-title":"Scrub typhus among hospitalised patients with febrile illness in south India: magnitude and clinical predictors","volume":"52","author":"Varghese","year":"2006"}],"container-title":["The American Society of Tropical Medicine and 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