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Differences in the clinical presentation and the frequency of complications between elderly and non-elderly scrub typhus patients.
[scrub typhus]
Age
can
affect
the
clinical
features
and
severity
of
infectious
disorders
,
such
as
scrub
typhus
.
We
performed
this
study
to
examine
differences
between
elderly
and
non-elderly
scrub
typhus
patients
,
and
to
identify
risk
factors
predictive
of
disease
outcomes
.
This
retrospective
study
included
patients
admitted
to
a
tertiary
hospital
with
scrub
typhus
between
2001
and
2011
.
A
total
of
615
patients
were
enrolled
in
this
study
,
328
of
which
were
>
65
years
of
age
.
Of
the
elderly
patients
,
46
.
0
%
(
151
/
328
)
experienced
at
least
one
complication
compared
to
only
23
.
0
%
(
66
/
287
)
in
younger
patients
.
A
linear
trend
was
observed
between
age
and
complication
rates
(
p
=
0
.
002
)
.
The
most
common
complication
in
elderly
patients
was
acute
kidney
injury
(
75
,
22
.
9
%
)
.
Treatment
failure
was
reported
in
10
elderly
patients
(
3
.
0
%
)
compared
to
one
non-elderly
patient
(
0
.
3
%
)
.
Mental
confusion
and
dyspnea
of
clinical
manifestations
at
admission
were
common
in
elderly
patients
.
Frequency
of
fever
,
rash
,
and
eschar
were
similar
in
both
groups
.
The
following
four
factors
were
significantly
associated
with
severe
scrub
typhus
in
elderly
patients
:
(
1
)
white
blood
cell
(
WBC
)
counts
>
10
,
000
/
mm
(
3
)
(
OR
=
2
.
569
,
CI
=
1
.
298
-
5
.
086
)
,
(
2
)
MDRD
GFR
<
60
mL
/
min
(
OR
=
3
.
525
,
CI
=
1
.
864
-
6
.
667
)
,
(
3
)
albumin
≤
3
.
0
g
/
dL
(
OR
=
4
.
976
,
CI
=
2
.
664
-
9
.
294
)
,
and
(
4
)
acute
physiology
and
chronic
health
evaluation
II
(
APACHE
II
)
score
>
10
points
(
OR
=
3
.
304
,
CI
=
1
.
793
-
60
.
87
)
.
Complications
and
mortality
were
more
common
in
elderly
patients
,
often
associated
with
delays
in
diagnosis
and
treatment
.
Diseases
Validation
Diseases presenting
"mental confusion"
symptom
scrub typhus
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