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Eschar in scrub typhus: a valuable clue to the diagnosis.
[scrub typhus]
Scrub
typhus
is
an
acute
febrile
illness
widely
prevalent
in
the
'
tsutsugamushi
triangle
'
region
of
the
world
.
Clinical
features
include
fever
,
myalgia
,
headache
,
rash
,
and
a
pathognomonic
eschar
.
An
eschar
is
formed
by
the
bite
of
chigger
mite
that
inoculates
the
causative
agent
of
Scrub
typhus
Orientia
tsutsugamushi
.
The
aim
of
this
study
is
to
determine
the
most
common
sites
of
eschars
over
the
bodies
of
patients
with
Scrub
typhus
.
In
a
retrospective
analysis
,
we
examined
a
total
of
418
patients
who
presented
to
Christian
Medical
College
,
Vellore
between
2009
and
2012
with
an
acute
febrile
illness
and
an
eschar
on
clinical
examination
and
confirmed
to
have
scrub
typhus
with
a
positive
Scrub
typhus
IgM
ELISA
test
.
We
studied
the
distribution
of
eschars
over
the
bodies
of
418
patients
with
Scrub
typhus
.
There
was
a
significant
difference
in
the
distribution
of
eschars
between
males
and
females
with
a
preponderance
of
the
chest
and
abdomen
(
42
.
3
%
)
among
females
and
the
axilla
,
groin
and
genitalia
(
55
.
8
%
)
in
males
.
Some
unusual
sites
of
an
eschar
were
the
cheek
,
ear
lobe
and
dorsum
of
the
feet
.
The
eschar
is
the
most
useful
diagnostic
clue
in
patients
with
acute
febrile
illness
in
areas
endemic
for
Scrub
typhus
and
therefore
should
be
thoroughly
examined
for
its
presence
especially
over
the
covered
areas
such
as
the
groin
,
genitalia
,
infra-mammary
area
and
axilla
.
Diseases
Validation
Diseases presenting
"useful diagnostic clue in patients"
symptom
scrub typhus
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