Scrub Typhus Fever - Causes, Diagnosis and Treatment by Dr. Shiv Dwivedi SignUp
Boloji.com
Boloji
Home Kabir Poetry Blogs BoloKids Writers Contribute Search Contact Site Map Advertise RSS Login Register
Boloji
Channels

In Focus

Analysis
Cartoons
Education
Environment
Going Inner
Opinion
Photo Essays

Columns

A Bystander's Diary
Business
My Word
PlainSpeak
Random Thoughts

Our Heritage

Architecture
Astrology
Ayurveda
Buddhism
Cinema
Culture
Dances
Festivals
Hinduism
History
People
Places
Sikhism
Spirituality
Vastu
Vithika

Society & Lifestyle

Family Matters
Health
Parenting
Perspective
Recipes
Society
Teens
Women

Creative Writings

Book Reviews
Ghalib's Corner
Humor
Individuality
Literary Shelf
Love Letters
Memoirs
Musings
Quotes
Ramblings
Stories
Travelogues
Workshop

Computing

CC++
Computing Articles
Flash
Internet Security
Java
Linux
Networking
Ayurveda Share This Page
Scrub Typhus Fever
- Causes, Diagnosis and Treatment
by Dr. Shiv Dwivedi Bookmark and Share
 

Introduction 

  1. Scrub typhus or bush typhus is a form of typhus caused by the intracellular parasite Orientia tsutsugamushi, a Gram-negative α-proteobacterium of family Rickettsiaceae first isolated and identified in 1930 in Japan.
  2. Scrub typhus is transmitted by some species of trombiculid mites ("chiggers", particularly Leptotrombidium deliense), which are found in areas of heavy scrub vegetation. The bite of this mite leaves a characteristic black eschar that is useful to the doctor for making the diagnosis.
  3. Scrub typhus is endemic to a part of the world known as the tsutsugamushi triangle (after O. tsutsugamushi) This extends from northern Japan and far-eastern Russia in the north, to the territories around the Solomon Sea into northern Australia in the south, and to Pakistan and Afghanistan in the west. It may also be endemic in parts of South America, too.
  4. It affects females more than males in Korea, but not in Japan, and which may be because sex-differentiated cultural roles have women tending garden plots more often, thus being exposed to vegetation inhabited by chiggers. The incidence is increasing in the southern part of the Indian subcontinent and in northern areas around Darjeeling.

Symptoms and Signs

  1. Incubation period of 6 to 21 days (mean 10 to 12 days).
  2. fever, chills, headache, and generalized lymphadenopathy start suddenely.
  3. muscle pain, cough, and gastrointestinal symptoms.
  4. Morbilliform rash, eschar, splenomegaly, and lymphadenopathies are typical signs. At onset of fever, an Escher often develops at the site of the chigger bite.
  5. The typical lesion of scrub typhus, common in whites but rare in Asians, begins as a red, indurated lesion about 1 cm in diameter; it eventually vesiculates, ruptures, and becomes covered with a black scab.
  6. Regional lymph nodes enlarge
  7. Fever rises during the 1st wk, often to 40 to 40.5° C. Headache is severe and common, as is conjunctival injection. A macular rash develops on the trunk during the 5th to 8th day of fever, often extending to the arms and legs.
  8. It may disappear rapidly or become maculopapular and intensely collared. Cough is present during the 1st wk of fever, and pneumonitis may develop during the 2nd wk.
  9. In severe cases, pulse rate increases; BP drops; and delirium, stupor, and muscular twitching develop. Splenomegaly may be present, and interstitial myocarditis is more common than in other rickettsial diseases. In untreated patients, high fever may persist ≥ 2 wk, then falls gradually over several days. With therapy, defervescence usually begins within 36 h. Recovery is prompt and uneventful.

Diagnosis

The cheapest and most easily available serological test is the Weil-Felix test, but this is notoriously unreliable.

Clinical features

Biopsy of rash with fluorescent antibody staining to detect organisms
Acute and convalescent serologic testing (serologic testing not useful acutely)
PCR

Treatment

  1. Doxycycline: Primary treatment is doxycycline 200 mg po once followed by 100 mg bid until the patient improves, has been afebrile for 48 h, and has received treatment for at least 7 days.
  2. Chloramphenicol 500 mg po or IV qid for 7 days is 2nd-line treatment.
  3. Clearing brush and spraying infested areas with residual insecticides eliminate or decrease mite populations. Insect repellents (eg, diethyltoluamide [DEET]) should be used when exposure is likely.

Vaccine

No licensed vaccines are available.

7-Oct-2017
More by :  Dr. Shiv Dwivedi
 
Views: 33
 
Top | Ayurveda







    A Bystander's Diary     Analysis     Architecture     Astrology     Ayurveda     Book Reviews
    Buddhism     Business     Cartoons     CC++     Cinema     Computing Articles
    Culture     Dances     Education     Environment     Family Matters     Festivals
    Flash     Ghalib's Corner     Going Inner     Health     Hinduism     History
    Humor     Individuality     Internet Security     Java     Linux     Literary Shelf
    Love Letters     Memoirs     Musings     My Word     Networking     Opinion
    Parenting     People     Perspective     Photo Essays     Places     PlainSpeak
    Quotes     Ramblings     Random Thoughts     Recipes     Sikhism     Society
    Spirituality     Stories     Teens     Travelogues     Vastu     Vithika
    Women     Workshop
RSS Feed RSS Feed Home | Privacy Policy | Disclaimer | Site Map
No part of this Internet site may be reproduced without prior written permission of the copyright holder.
Developed and Programmed by ekant solutions