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FEVER AND RASH CAN BE SCRUB TYPHUS INFECTION

It is a mite born rickettsial infection firstly identified in Japan in 1930. It is caused by Orientia tsutsugamushi.
 
Mode of transmission:
Humans are the accidental hosts. Bite of an infected mite which feeds on small mammals (rats and mites) causes infection to humans. There is no direct person to person transmission.


Prevails in rainy seasons and area of scrub vegetation. Find the top child specialist in sector 57 gurgaon.

Clinical features:
Incubation period is between 6-21 days
•    High fever with chills
•    Malaise
•    Maculopapular rash
•    Lymphadenopathy
•    Coryza
•    Headache
•    Gastrointestinal symptoms
•    Eschar formation on 5th day of illness. Mostly located in axillary, inguinal region, perianal, scrotum, buttocks and thigh. It appears as an ulcer surrounded by a red areola which is covered by scab.

Complications:
•    Pneumonitis
•    Hepatitis
•    Meningoencephalitis
•    Disseminated intravascular coagulation
•    Myocarditis
•    Multi organ failure

Investigations:
•    Weil-feilx test- cheapest and most easily available serological test
•    Indirect immunofluorescence
•    PCR

Management:
•    Drug of choice is tetracycline
•    But doxycycline orally or chloramphenicol can be used
•    Azithromycin and Rifampicin can be used in resistant cases

Prevention:

Use of insecticides, hygiene and human protection is utmost important
Points to remember:
•    Scrub typhus is re emerging disease in India
•    Search for an eschar in hidden areas of body
•    Weil Feilx is cheap and easily available test
•    Doxycycline is the drug of choice
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