Original Research Article
Year: 2020 | Month: March | Volume: 10 | Issue: 3 | Pages: 48-54
Renal Manifestations of Scrub Typhus - in a Tertiary Care Centre of North India 2018-19
Satish Kumar1, Virendra Atam2, Satyendra Kumar Sonkar3, Ajay Kumar4, Amit Kumar1, Shyam Chand Chaudhary3
1Senior Resident, 2Professor and Head, 3Professor, 4Associate Professor,
Department of Medicine, King George’s Medical University, Lucknow, India.
Corresponding Author: Satish Kumar
ABSTRACT
Background- Kidney involvement is an important finding in scrub typhus. A retrospective cross sectional study was done to find out the occurrence, course of disease, urinary abnormalities, complications, outcomes and the risk factors determining acute kidney injury (AKI) in cases with scrub typhus.
Methods- Out of 484 admitted patients with acute febrile illness from July 2018 to April 2019, data of 204 patients of Scrub Typhus detected by “IgM ELISA test (titre equal or more than 0.5) were analysed.
Results- Maximum patients 172 (84%) were admitted from August to December and all belonged to rural and semi-urban area. In AKI group there was male preponderance. (OR=6, p<0.05). In 32% of patients urinary abnormality was found. Mean serum creatinine was 2.82±1.67mg/dl.AKI was seen in 72 (35.3%) of patients with stage 1 (33.3%), stage 2 (44.4%) and stage 3 AKI (22.3%). Haemodialysis was required in 12 (16.7%) patients. Overall mortality was seen in 44 (21.56%) patients, and it was higher in cases with AKI (44.4% vs. 9.4%; p <0.005).
Conclusion- Scrub typhus is an important cause of acute febrile illness which causes multiple organ dysfunction syndrome and it is easily treatable but most ignored disease. AKI development in patients of scrub typhus may predict grave prognosis.
Key words: Scrub typhus, Acute Kidney Injury, Acute respiratory distress syndrome, Shock, hemodialysis