Possibility of scrub typhus in fever of unknown origin (FUO) cases: An experience from Rajasthan.
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Date
2014-10
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Abstract
Purpose: Fever of unknown origin (FUO) has multiple causes. Scrub typhus is less known cause of FUO in India. The
present study reports a recent epidemic of scrub typhus amongst cases of FUO from different areas of Rajasthan, India.
There was high mortality in undiagnosed cases of FUO which lead to the diagnosis of scrub typhus. Objective: To
study the possibility of scrub typhus as a causative factor in FUO cases by qualitative detection of IgM antibodies with
ELISA. Materials and Methods: From September 2012 to December 2012, 271 serum samples of FUO cases were
analysed for IgM antibodies to Orientia tsutsugamushi along with dengue, malaria, typhoid, tuberculosis and brucellosis.
Results: Scrub typhus IgM antibodies by ELISA were detected in 133 (49.1%) patients. Scrub typhus positivity was
significantly higher among female in comparison to males (P < 0.05). Maximum positivity of scrub typhus was found
in females of 46‑60 years age group. The laboratory parameters were abnormal in most of the patients as evident by
thrombocytopenia (63%), deranged liver functions (56%) and renal functions (25%). Conclusion: The present study
emphasises the importance of scrub typhus among cases of FUO especially after rainy season and during early cooler
months. The study also highlights the significance of ELISA method for rapid and early reporting and ruling out scrub
typhus in FUO cases.
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Keywords
ELISA, Fever of unknown origin, Orientia tsutsugamushi, Scrub typhus
Citation
Bithu R, Kanodia V, Maheshwari R K. Possibility of scrub typhus in fever of unknown origin (FUO) cases: An experience from Rajasthan. Indian Journal of Medical Microbiology. 2014 Oct-Dec ; 32 (4): 387-390.