Scrub typhus Flashcards
Scrub typhus - organism
Orientia tsutsugamushi
Gram negative intracellular bacteria in rickettsia family
Scrub typhus - vector
Larval trombiculid mite
Scrub typhus - burden
1 million cases/year
Scrub typhus - geographical distribution
South-east Asia - tsutsugamushi triangle
Scrub typhus - clinical presentation
IP 6-21 days
55% painless eschar
Fever, fatigue, frontal HA, myalgia, cough
Delayed generalised maculopapular rash
Lymphadenopathy
Mortality 1-8%
Similar presentation to Dengue
Ddx febrile illness - southern India
Dengue
Scrub typhus
Malaria
Leptospirosis
Typhoid
Scrub typhus - pathogenesis
Widespread vasculitis and perivasculitis - accompanied by infiltration of mononuclear cells into affected organs
Scrub typhus - clinical score to differentiate from dengue
Score <13 favours scrub typhus
Score >13 favours dengue
Scrub typhus - diagnosis
IFA
Scrub typhus - treatment
Doxycycline
OR
Azithromycin
OR
Chloramphenicol
Scrub typhus - prevention
Repellents
Avoid direct contact with ground
For high risk people - doxycycline 200mg weekly suppresses disease but may not prevent infection
