Clinical manifestation, laboratory characteristics and predictors of severity in scrub typhus patients hospitalized in 103 Military Hospital and 108 Military Central Hospital

Abstract

Objective: To investigate clinical manifestation, laboratory characteristics and predictors of severity in scrub typhus patients hospitalized in 103 Military Hospital and 108 Military Central Hospital. Subject and method: This was a descriptive study on 50 cases of scrub typhus confirmed by dot-ELISA or PCR hospitalized in 103 Military Hospital and 108 Military Central Hospital. Result and conclusion: There were 62% male and 38% female in our study. Patients in urban and non-urban accounted for 36% and 64%, respectively. The majority of patients had fever, headache and myalgia (> 96%) followed by eschar 70%, congested skin 60%, lymphadenopathy 44%, cough 42%, crackle 36%, dyspnea 22%. Thrombocytopenia and elevated liver enzyme accounted for 70% and more than 88, respectively. 100% patients had elevated PCT ( ± SD 2.396 ± 2.119ng/ml). Lung involvements on chest X-ray: Patchy opacity 8.7%, unilateral infiltrate 10.9%, bilateral infiltrate 8.7%. Pleural effusion and serous fluid on ultrasound were 30.8% and 33.3% respectively. Complications included respiratory failure 12%, septic shock 8%, and meningoencephalitis 8%, acute kidney injury 8%. Factors such as shortness of breath (OR = 6.6), respiratory rate ≥ 22 cycles/minutes (OR = 8.16), moist rale (OR = 14.25), increased PCT (AUC = 0.75), diffuse infiltration on X-rays (OR = 18), pleural fluid on ultrasound (OR = 5.17), have associated with the life-threatening complications (p<0.05).