ABSTRACT
AIM: To describe the clinical features, laboratory manifestations, complications in patients diagnosed with scrub typhus at a tertiary care hospital in south India. MATERIAL AND METHODS: All cases of acute onset fever diagnosed to have scrub typhus August 2011 to December 2012 were analysed. Cases of scrub typhus confirmed by the well felix test with a titre of 1 in 80 or more and a positive immunochromatography test were studied. RESULTS: 176 confirmed cases of scrub typhus were studied over a period of 18 months. Majority (96%) of patients are from rural background. Farmers constituted 60% of the patients. Most common symptoms were due to the involvement of respiratory tract in the form of cough in 94 (53%) patients followed by breathlessness in 84 (47.7%). Signs of consolidation were seen in 80 (45.5%). Central nervous system involvement in the form of altered sensorium was seen in 43 (24.4%) and seizures in 11 (6.3%) patients. Eshcar was seen in 23 (13%) patients. Transaminases were elevated in 153 (86%) patients, serum alkaline phosphatase in 110 (62.5%) patients. Renal failure was seen in 49 (27.8%) cases and respiratory failure was seen in 11 (6.2%). Eight (4.5%) patients died in our study. CONCLUSION: Scrub typhus should be suspected in patients with rural background with fever and multi system involvement. The predominant symptoms were cough and breathlessness. Central nervous system abnormalities in the form of altered sensorium was seen in 43 (24.4%). Most common laboratory abnormality noted in our patients with scrub typhus was elevated liver enzymes which were seen in 153 (86%) cases.
Subject(s)
Disease Outbreaks , Scrub Typhus/epidemiology , Adult , Female , Humans , India/epidemiology , Male , Retrospective Studies , Tertiary HealthcareABSTRACT
An unusual presentation of a viperine snake bite presenting with ischaemic damage to the major organs like brain and heart leading to cerebrovascular accident and acute myocardial infarction along with acute renal failure and disseminated intravascular coagulopathy (DIC) is described in this report.
Subject(s)
Acute Kidney Injury/diagnosis , Cerebrovascular Disorders/diagnosis , Disseminated Intravascular Coagulation/diagnosis , Myocardial Infarction/diagnosis , Snake Bites/diagnosis , Viperidae , Adult , Animals , Diagnosis, Differential , Fatal Outcome , Humans , India , Male , Severity of Illness IndexABSTRACT
Infection with the Human Immunodeficiency Virus (HIV) has an increasing, direct and significant impact on the hospital, especially the emergency services. Out of a total of 39,876 patients screened, 1061 patients were reactive for anti-HIV antibodies. The incidence of the infection showed a remarkable progression from 0.89% in 1992-1993 to 5.6% in 1997, among the seropositive patients. The number of patients with signs and symptoms related to HIV infection has also shown a 2 fold rise (from 42% in 1992-1993 to 87% in 1997). The prevalence of HIV 1 in the seropositive patients is 93%, HIV 2 alone is 2.3% and 3.1% had a mixed infection with both HIV 1 and 2. Secondary infection with Mycobacteria ranked high (25%) among the symptomatic patients, with pulmonary and the disseminated varieties being more common.