Acute renal failure in scrub typhus patients

Abstract

Scrub typhus, a bacterial infection caused by Orientia Tsutsugamushi (formally Rickettsia) due to bite of the mite, and is increasing every year, and becomes a important cause of acute febrile illnesses. Due to lack of specific diagnostic facilities in most rural setups and non-specific clinical presentations, it becomes a challenge for clinician to correctly diagnose it on clinical examination. Clinically it presents with non-specific febrile illnesses with constitutional symptoms such as fever, rash, myalgia and headache or with organ dysfunction involving kidneys, lungs, liver, central nervous system or with circulatory collapse with hemorrhagic features. Eschar is the characteristic lesion which is present at the bite site of mite. Later an ulcer with black necrotic centre and regional lymphadenopathy occurs. Renal involvement in the form of Acute Renal Failure is seen very occasionally in these patients. So this Case-control study is designed for a period of six months which are october-2018 to march-2019, comparing 80 ELISA(Enzyme Linked Immune Sorbent Assay) confirmed cases of scrub typhus and 50 healthy controls. Statistically significant difference in Urea, Creatinine and Uric acid levels were found between two groups, using 't'-test with the significance value of P<0.0001.