Assessment of rickettsial diseases presenting as acute undifferentiated febrile illness using clinical tools in a government tertiary care teaching hospital, Chamarajanagar, Karnataka
Keywords:
rickettsial diseases, acute undifferentiated febrile illness, doxycyclineAbstract
Background: Rickettsial diseases are re-emerging in India. Acute undifferentiated febrile illness is a difficult case to treat (AUFI). The greatest problem for clinicians is the early diagnosis of these diseases when antibiotic therapy is most successful.To determine the prevalence of RDs, therapy outcomes, and socio-demographic factors associated with RDs in AUFI. Patients and Methods: Fever and/or clinical signs of Rickettsial infection in patients admitted to the CIMS teaching hospital in Chamarajanagar for four years. Purposive sampling found AUFI in 1638 people. The diagnosis of rickettsial disease relied on clinical features. The Weil-Felix test was one. Then came a 48–72-hour estimate of doxycycline response. Results:Out of 1810 AUFI cases, 198 (10.93%) were rickettsial, with 190 (95.95%) having an RGA score of 14 or more, and 18 (9.09%) having an RGA score of 14 or less. Males aged 30-40 were most affected. Leucopenia, thrombocytopenia, etc. were found. Doxycycline was effective in 151 (89.35%) of cases within one week of onset. The remaining 18 (10.65%) required longer-term doxycycline with other drugs, three had severe complications, and one died. RD prevalence 70.01 %. Enteric fever, Dengue fever, Chikungunya fever, and Rickettsial diseases were the most common diseases diagnosed in patients with undifferentiated febrile illness.
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Daniel. H. Paris, Nicholas P.J.DAY: Tropical Rickettsial Infections. Manson’s Tropical Diseases. 23rd edi. Jeremy Farrar, Peter J Hotez, Thomas Jughanss, Gagandeep Kang. Elsevier Saunders; 2014:273-274.
Brezina R, Murray E S, Tarizzo M L, Bogel K: Rickettsiae and rickettsial diseases, Bull Wld Hlth Org; 1973,49:433-442. https://apps.who.int/iris/handle/10665/263630.
R.K.Srivastava, D.Bhattacharya, Veena Mittal, Naveen Gupta., et al.,.: Scrub Typhus & other Rickettsioses. CD Alert, National Centre for Disease Control, Directorate General of Health Services, Govt. of India;2019,13(1):01-8.
Sophia G de Vries, Louise E van Eekeren, Hans Van der Linden, etal.: Searching and finding the Hidden Treasure: A Retrospective Analysis of Rickettsial Diseases Among Dutch International Travelers. Clinical Infectious Diseases;2021,72(7):1171-1178.
Blewitt B: Fever of the Typhus group in the BhimTal area, Kumaon Hills,UP, India. J of Royal Army Medical Corps; 1938:241-245.
Rajeev Raiana: Rickettsial Infections. API Textbook of Medicine.11th edi., Vol.1: Sandhya A Kamath, Siddharth N Shah, Millind Y Nadkar. The Association of Physicians of India, CBS; 2019:229-232.
Seena Sankar, Shruthi Kulkarni & Kurian Thomas: A Study on Clinical Profile and Complications of Rickettsial Diseases in a Tertiary Care Hospital: Prospective Observational Study: International Journal of current Medical and Applied sciences; 2017, 14(1),20-25.
Tabeen Mansoor, Bashir Ahmad Fomda, Ajaz Nabi Koul, et al.,.: Rickettsial Infections among the Undifferentiated Febrile Patients attending a Tertiary Care Teaching Hospital of Northern India: A Longitudinal Study. Infect Chemother; 2021,53(1):96-106.
Manisha Biswal, Sivanantham Krishnamoorthi, Kamesh Bisht, et al.,.:Rickettsial Diseases: Not Uncommon Causes of Acute Febrile Illness in India. Trop. Med. Infect. Dis; 2020,5(59):1-10.
Rathi M, Gupte MD, Bhargava A, Varghese GM, Arora R. DHR-ICMR guidelines for diagnosis and management of Rickettsial diseases in India. Indian J Med Res. 2015;141:417-22.
Bhaskar Naik, A Sailaja, T anusha, et al.,.: A prospective study of the effectiveness of clinical RGA (Rathi Goodman Aghai) Score in relation with PCR in the diagnosis of Scrub Typhus. International J of Paediatrics & Geriatrics; 2019,2(2):01-05
Satish Talikoti, Nijora Deka: Clinical profile of Rickettsial Infection in Vijayapur, North Karnataka- A Retrospective Study. J.Evid.Based Med.Health C;2019,16(22):1563-1566.
Vasantha Kamath, Sheryashi Ganguly, Jasmine Kaur Bhatia, R Himabindhu: Rickettsial Infections: Past and Present Perpectives.APIK J of Int Med;2020,8:4-10.
P Saravanan, M V Nagaraj, C Somashekar: Rickettsial fever in tertiary care hospital in rural Bengaluru: Clinical profile and complications. Indian J Child Health;2020,7(9):385-387.
Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in the Himalayan region of India. Jpn J Infect Dis 2005;58:208-10.
Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E. Serological evidence for wide distribution of spotted fevers and typhus fever in Tamil Nadu. Indian J Med Res 2007;126:128-30.
Bithu R, Kanodia V, Maheshwari RK. Possibility of scrub typhus in fever of unknown origin (FUO) cases: An experience from Rajasthan. Indian J Med Microbiol 2014;32:387-90.
Prakash JA, Abraham OC, Mathai E. Evaluation of tests for serological diagnosis of scrub typhus. Trop Doct 2006;36:212-3.
Mallesh K, Sarala Sabapathy, Rashmi Patil, Nikarika Shettty: Clinicopathological profile of rickettsial fever in tertiary healthcare centre: a prospective case study. Int J of Contemp Pediatr; 2020,7(5):1003-1007.
Thomas R, Puranik P, Kalam B, Britto C, Savita K, Rego S, et al.,. Five-year analysis of rickettsial fever in children in south India: Clinical manifestations and complications. J Infect Dev Ctries. 2016;10(6):657-661.
Murali N, Pillai S, Cherian T, Raghupathy P, Padmini V, Mathai E. Rickettsial infections in south India-how to spot the spotted fever. Indian Pediatr. 2001;38:1393-6.
Kumar M, Krishnamurthy S, Delhikumar CG, Narayanan P, Biswal N, Srinivasan S. Scrub typhus in children at a tertiary hospital in southern India: clinical profile and complications. J Infect Public Health. 2012;5:82-8.
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