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Tropical fevers: Management guidelines.
[scrub typhus]
Tropical
fevers
were
defined
as
infections
that
are
prevalent
in
,
or
are
unique
to
tropical
and
subtropical
regions
.
Some
of
these
occur
throughout
the
year
and
some
especially
in
rainy
and
post-rainy
season
.
Concerned
about
high
prevalence
and
morbidity
and
mortality
caused
by
these
infections
,
and
overlapping
clinical
presentations
,
difficulties
in
arriving
at
specific
diagnoses
and
need
for
early
empiric
treatment
,
Indian
Society
of
Critical
Care
Medicine
(
ISCCM
)
constituted
an
expert
committee
to
develop
a
consensus
statement
and
guidelines
for
management
of
these
diseases
in
the
emergency
and
critical
care
.
The
committee
decided
to
focus
on
most
common
infections
on
the
basis
of
available
epidemiologic
data
from
India
and
overall
experience
of
the
group
.
These
included
dengue
hemorrhagic
fever
,
rickettsial
infections
/
scrub
typhus
,
malaria
(
usually
falciparum
)
,
typhoid
,
and
leptospira
bacterial
sepsis
and
common
viral
infections
like
influenza
.
The
committee
recommends
a
'
syndromic
approach
'
to
diagnosis
and
treatment
of
critical
tropical
infections
and
has
identified
five
major
clinical
syndromes
:
undifferentiated
fever
,
fever
with
rash
/
thrombocytopenia
,
fever
with
acute
respiratory
distress
syndrome
(
ARDS
)
,
fever
with
encephalopathy
and
fever
with
multi
organ
dysfunction
syndrome
.
Evidence
based
algorithms
are
presented
to
guide
critical
care
specialists
to
choose
reliable
rapid
diagnostic
modalities
and
early
empiric
therapy
based
on
clinical
syndromes
.
Diseases
Validation
Diseases presenting
"usually falciparum"
symptom
scrub typhus
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