Comparison of classification criteria for severity in scrub typhus

Aims: To study classification criteria for severity in scrub typhus admitted in a tertiary care hospital.
Material and Methods: 180 patients of scrub typhus were included in the study. Diagnosis was confirmed by IgM ELISA. Baseline characteristics of patients were recorded. Patients were analyzed by severe sepsis and organ dysfunction criteria. Outcomes by two criteria were compared.
Observations: Out of 180 patients, 130 were females (72%).Organ dysfunction was present in 30% of patients, severe sepsis was present in 36% patients. Mortality occurred in 6.7% patients. Relative risk of death was 6.0 in patients having organ dysfunction, compared to 2.4 in patients having severe sepsis.
Conclusion: Scrub typhus is an important cause of mortality. Identifying patients which may develop fatality, early in the disease course can prevent mortality. Organ dysfunction better predicts mortality and fatal outcome increases with worsening dysfunction.