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Possibility of scrub typhus in fever of unknown origin (FUO) cases: An experience from Rajasthan.
[scrub typhus]
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
.
To
study
the
possibility
of
scrub
typhus
as
a
causative
factor
in
FUO
cases
by
qualitative
detection
of
IgM
antibodies
with
ELISA
.
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
.
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
%
)
.
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
.
