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Possibility of scrub typhus in fever of unknown origin (FUO) cases: An experience from Rajasthan.
[typhoid]
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
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated