{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:13:13Z","timestamp":1789398793167,"version":"build-2803163510"},"reference-count":0,"publisher":"Jaypee Brothers Medical Publishing","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPI"],"published-print":{"date-parts":[[2023,5,7]]},"abstract":"<jats:p>Aim: To describe coagulation abnormalities and their association with complications in patients  with severe scrub typhus. Materials and methods: A cohort study was conducted among all patients of severe scrub typhus  [immunoglobulin M (IgM) positive] who reported to this facility from 1st August 2019 to 31st July  2020 and met our inclusion criteria. We estimated the incidence of severe thrombocytopenia  (&lt;50,000\/\u00b5L) and overt disseminated intravascular coagulation (DIC) (DIC score of \u22655). We  determined the association [risk (RR) ratios] of these abnormalities with complications of scrub  typhus, namely\u2014septic shock, multiple organ dysfunction syndrome (MODS), and septic shock  with MODS. Results: In total, 71 patients were studied with a mean age of 50 \u00b1 15.5 years, of which 45 (63.4%)  were females. On presentation, fever 70 (98.5%), myalgias 22 (31.0%), loose stools 13(18.3%), cough,  vomiting, headache 11 (15.5%), altered sensorium 10(14.1%), and pain abdomen 9 (12.7%) were  main symptoms. On examination, hypotension 31 (43.7%), eschar 25 (35.2%), icterus 17 (23.9%),  and rash 16 (22.5%) were noted. The d-dimer (&gt;0.5 \u00b5g\/mL) levels were increased in all (100%) patients. Thrombocytopenia  (91.5%) was the commonest hematological abnormality and 31 (43.6%) of them had severe  thrombocytopenia, 25 (35.2%) patients had low fibrinogen levels (&lt;200 mg\/dL) and prothrombin  time (PT &gt;16.7 seconds) was prolonged in 20 (28.1%). A total of 42 (59.1%) patients developed MODS, 33 (46.4%) developed septic shock, 24 (33.8 %)  had MODS with septic shock, 17 (23.9%) developed overt DIC, and eight (11.2%) died. Severe  thrombocytopenia (p = \u22120.028) and overt DIC (p = 0.045) were significantly associated with septic  shock development. Conclusion: In the patients admitted with severe scrub typhus; thrombocytopenia was the  commonest hematological abnormality. The development of septic shock was significantly  associated with severe thrombocytopenia and overt DIC.<\/jats:p>","DOI":"10.5005\/japi-11001-0237","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T05:18:21Z","timestamp":1686633501000},"page":"29-32","source":"Crossref","is-referenced-by-count":3,"title":["Coagulation Abnormalities in Severe Scrub Typhus and Their  Association with Complications"],"prefix":"10.59556","volume":"71","author":[{"given":"Deepti","family":"Singla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balraj","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal","family":"Ahire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay K","family":"Mahajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2914","published-online":{"date-parts":[[2023,5,1]]},"container-title":["Journal of the Association of Physicians of India"],"original-title":[],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:57:35Z","timestamp":1745578655000},"score":1,"resource":{"primary":{"URL":"https:\/\/japi.org\/article\/files\/JAPI0237_p29-32_compressed.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":0,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2023,5,1]]},"published-print":{"date-parts":[[2023,5,7]]}},"URL":"https:\/\/doi.org\/10.5005\/japi-11001-0237","relation":{},"ISSN":["0004-5772"],"issn-type":[{"value":"0004-5772","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}