scholarly journals Dengue and Scrub Typhus Coinfection in a Patient Presenting with Febrile Illness

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Surendra Sapkota ◽  
Sudeep Bhandari ◽  
Subash Sapkota ◽  
Rabin Hamal
Keyword(s):  
Dengue Fever ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Laboratory Parameters ◽  
Vector Borne Diseases ◽  
Common Causes ◽  
Vector Borne ◽  
High Degree ◽  
Timely Treatment

Dengue fever and scrub typhus are common causes of acute febrile illness of unclear origin in Asia. Though coinfections of many vector-borne diseases have been described, articles on dengue and scrub typhus coinfection are distinctly limited. In case of coinfection with dengue and scrub typhus, vigilant monitoring of vitals, platelets transfusion, and timely treatment with doxycycline are necessary. High degree of suspicion has to be made for coinfection in a patient presenting with febrile illness with thrombocytopenia and deranged laboratory parameters in postmonsoon season in endemic regions in Asia.

An infection cocktail: malaria, dengue, chikungunya and Japanese encephalitis

2018 ◽  
Vol 49 (1) ◽  
pp. 42-43
Author(s):  
Nishanth Dev
Keyword(s):  
Japanese Encephalitis ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Healthcare Facilities ◽  
Laboratory Parameters ◽  
Vector Borne Diseases ◽  
Altered Sensorium ◽  
First Case ◽  
Significant Burden ◽  
Vector Borne

Vector-borne diseases cause a significant burden on healthcare facilities. An increasing number of cases reported with multiple co-infections only add to the ordeal. The presence of co-infection may modify clinical and laboratory parameters significantly making diagnosis and treatment a challenge. Cases of malaria and dengue with other infections such as chikungunya, leptospirosis and hepatitis have been reported previously. We report a case of acute febrile illness with altered sensorium which was eventually diagnosed to have quadruple infection with malaria, dengue, chikungunya and Japanese encephalitis. This may be the first case with four concurrent vector-borne infections, all of which are transmitted by mosquitoes.

scholarly journals Scrub Typhus and Molecular Characterization of Orientia tsutsugamushi from Central Nepal

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 422
Author(s):  
Rajendra Gautam ◽  
Keshab Parajuli ◽  
Mythili Tadepalli ◽  
Stephen Graves ◽  
John Stenos ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Limited Information ◽  
Orientia Tsutsugamushi ◽  
Health Measures ◽  
Central Nepal ◽  
Vector Borne

Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.

scholarly journals Differentiating Scrub Typhus, Dengue Fever and Typhoid Fever in Indian Children Presenting with Acute Febrile Illness

2020 ◽  
Vol 40 (2) ◽  
pp. 93-99
Author(s):  
Saheli Misra Chatterjee ◽  
Suman Mondal ◽  
Kaushik Mukhopadhyay ◽  
Niloy Kumar Das
Keyword(s):  
Dengue Fever ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Indian Children ◽  
Diagnostic Dilemma ◽  
Female Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Introduction: The disease spectrum of dengue, scrub typhus and typhoid presenting as acute febrile illness is often a diagnostic dilemma to the clinician. The purpose of this study is to compare the clinical features and laboratory parameters of children suffering from typhoid, dengue and scrub typhus and use these parameters in early identification of scrub typhus before conclusion is made from serological diagnosis. Methods: A retrospective observational analytical study was conducted among children presenting with acute febrile illness in a tertiary care level hospital. Over the period of one year 113 cases were identified of which 39 were dengue, 44 were typhoid and 30 were scrub typhus. Results: The mean age of the children was 7.45 ± 2.98 years, median was eight with an interquartile range of six to ten years. The male to female ratio was 1.3:1. Symptoms of vomiting (61.54%), headache (46.15%) and hepatomegaly (47.37%) were significantly higher among children with dengue fever. A significantly higher number of children with scrub typhus fever had temperature above 40°C. The incidence of low haemoglobin, raised C reactive protein, raised ALT and low albumin levels were significantly higher in them. Children with acute febrile illness having temperature > 40°C, absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to suffer from scrub typhus with relative probability ratio (RPR) of 25.68 and 10.57 respectively (p < 0.001). Children with WBC < 5000/mm3 were more likely to be suffering from dengue with RPR of 10.60 (p < 0.001). Conclusion: Children with acute febrile illness with temperature > 40°C and absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to be suffering from scrub typhus.

scholarly journals Concurrent dengue and typhoid infection: study from a tertiary care centre in Muzaffarnagar, India

2019 ◽  
Vol 7 (5) ◽  
pp. 1615
Author(s):  
Sapna Chauhan ◽  
Sachin Sharma ◽  
Surender . ◽  
Paramjit Singh
Keyword(s):  
Tertiary Care ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Widal Test ◽  
Tertiary Care Centre ◽  
Diagnostic Dilemma ◽  
Vector Borne Diseases ◽  
Ns1 Antigen ◽  
Arboviral Diseases ◽  
Vector Borne

Background: Acute febrile illness is a common presenting complaint during the rainy season. Rains predispose to both water and vector borne diseases. Co-infection of dengue with malaria, leptospirosis, typhoid, scrub typhus and other arboviral diseases can occur in endemic areas. Such dual infections are difficult to diagnose and create a diagnostic dilemma for the treating physician. Here in this study authors attempt to find out rates of concurrent dengue and typhoid infection.Methods: This retrospective study was done between August to November 2017. 403 patients presenting with acute febrile illness were studied. Diagnosis of dengue was done by rapid card test detecting NS1 antigen, IgM and IgG antibodies. Serodiagnosis of Salmonella infection was done by tube Widal test.Results: : Out of 403 febrile sera samples tested 154 (38.2%) were positive for dengue (either NS1 antigen or IgM antibodies or both), 71(17.6%) were positive for Widal test O and H titres ≥1:160) and 28 (6.9%) were positive for both dengue as well as Salmonella (Widal test).Conclusions: Acute febrile illnesses with diagnostic dilemma may be seen in cases of co-infection. Only better clinical judgement and right choice of laboratory tests can diagnose these diseases timely and prevent fatal outcomes.

scholarly journals Scrub typhus in third trimester of pregnancy: dilemmas in diagnosis and management

2020 ◽  
Vol 10 (1) ◽  
pp. 413
Author(s):  
Geeta Jain ◽  
Preeti Priyadarshani ◽  
Garima Sisodia
Keyword(s):  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
High Grade ◽  
Third Trimester ◽  
High Grade Fever ◽  
The Third ◽  
Timely Treatment ◽  
In Pregnancy

Scrub typhus is an acute febrile illness rarely diagnosed in pregnancy. Here we report a case of scrub typhus in the third trimester of pregnancy, its associated complications and its management to ensure a favourable fetomaternal outcome. Mrs X, a 22- year old primigravida, was diagnosed with scrub typhus at 38 weeks of pregnancy after developing high- grade fever for 12 days. An atypical eschar was seen on one foot. Her ultrasonography revealed foetal tachycardia and severe oligohydramnios. She was started on tab azithromycin 500 mg OD but remained febrile even after two days. Fever subsided at dose of 1gm/day. When she was afebrile for 48 hours and adequately hydrated, labour was induced and she delivered vaginally a full-term alive baby of 2.2 kg. Vertical transmission was not observed in the baby. Scrub typhus is an easy-to-treat cause of acute undifferentiated febrile illness in the Indian subcontinent, and should always be a differential diagnosis even in the absence of a pathognomic eschar. Timely treatment ensures a favourable fetomaternal outcome.  

scholarly journals Scrub typhus: a hospital-based study in the northern districts of West Bengal, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2403
Author(s):  
Sanjay Kumar Mallick ◽  
Santanu Hazra ◽  
Tanmoy Nandi ◽  
Arunabha Sarkar
Keyword(s):  
Case Fatality Rate ◽  
West Bengal ◽  
Scrub Typhus ◽  
Case Fatality ◽  
Febrile Illness ◽  
Asia Pacific ◽  
Enzyme Linked Immunosorbent Assay ◽  
Acute Febrile Illness ◽  
Fatality Rate ◽  
Serological Tests

Background: Scrub typhus caused by Orientia tsutsugamushi, is a mite-borne zoonotic acute febrile illness. Geographically, it is confined to the Asia-Pacific region and important re-emerging infection in India. Clinical diagnosis of scrub typhus from other acute febrile illness is very difficult due to nonspecific symptoms and the relative absence of eschar in the Indian population. Case fatality rate varies from 30-70% depending on the clinical suspicion, delay in diagnosis and treatment. Antibody-based serological tests are the mainstay of diagnosis. IgM enzyme-linked immunosorbent assay (ELISA) against O. tsutsugamushi is helpful for the diagnosis of scrub typhus within the first week of illness.Methods: The aim of the study was to determine the prevalence of the disease in Northern districts of West Bengal, India using IgM ELISA.Results: Out of 577 serum samples tested 10.05% were positive for IgM antibodies. Majority of cases were below 40 years of age with higher prevalence in female patients. The disease showed a seasonal trend with a peak during the monsoon and later months. The case fatality rate among ELISA positive cases was 32.76%.Conclusions: Significant seropositivity against scrub typhus among cases of acute febrile illness with relatively higher mortality indicates that scrub typhus should be included in the differential diagnosis and confirmed by IgM ELISA.

scholarly journals Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal

2020 ◽  
Author(s):  
Rajendra Gautam ◽  
Keshab Parajuli ◽  
Tshokey Tshokey ◽  
John Stenos ◽  
Jeevan Bahadur Sherchand
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Gold Standard ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Immunofluorescence Assay ◽  
Acute Febrile Illness ◽  
Central Nepal ◽  
Igm Elisa ◽  
Typhus Fever

Abstract Introduction Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Methodology Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively. Conclusion The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.

scholarly journals Development Innovation to Predict Dengue Affected Area and Alert People with Smartphones

2020 ◽  
Vol 16 (02) ◽  
pp. 62 ◽  
Author(s):  
Patsaraporn Somboonsak
Keyword(s):  
Dengue Fever ◽  
Fog Computing ◽  
Arima Model ◽  
Application Development ◽  
Vector Borne Diseases ◽  
Traffic Lights ◽  
The People ◽  
Dengue Outbreaks ◽  
Vector Borne ◽  
Self Driving Cars

<p class="0abstract">Dengue remains a significant problem that needs to be addressed urgently in Thailand. Although Thailand has spread the dengue fever for more than sixty years, however, it is still found dengue patients in every province and spread to various areas. There is also a variable pattern of disease occurring each year, so it is necessary to have tools to help forecast area to allow the related organization and the people in the area plan to prevent dengue fever that may occur next year. This research aimed to create innovation for predicting dengue fever regions, namely ThaiDengue, by collecting data from dengue patients in Chatuchak District, Bangkok, Thailand, from January 2014 to December 2018. There was a total of 358,524 dengue patients from the Bureau of vector-borne diseases applied to the prediction of patients in the next year with the ARIMA model (1,1,0) (1,1,0). It is predicted that in 2019, Thailand will have dengue patients around 95,000 cases, which has the number of dengue patients close to the year 2018. In the next step, application development and database on fog computing. Fog computing is an evolving technology that brings the benefits achieved by could computing to the periphery of the network devices for faster data analytics. It is better suited than cloud computing for meeting the demands of numerous emerging applications such as self-driving cars, traffic lights, smart homes. While the ThaiDengue consists of the main menu: how to use, forecast, surveillance calendar, notification, disease map, notify patients, contact the Bureau of vector-borne, knowledge information, and scan the QR code. After that, the result of the development, the researcher has the Bureau of vector-borne disease of Thailand used to forecasts, create a GPS map of dengue outbreaks, and create a calendar for dengue monitoring.  After that, send a message to alert the people in the area of dengue via a smartphone and send additional emails. The results from using the application found this application can be used as a tool to help the Bureau of vector-borne diseases, to plan dengue fever control and alert the people in the risk areas of dengue outbreak and users are very satisfied with the use of the application.</p>

scholarly journals In Vitro Susceptibility of Rickettsia Species to Eravacycline, Omadacycline, and Tigecycline

2021 ◽  
Author(s):  
Bethany R. Quade ◽  
Alejandro Ramírez-Hernández ◽  
Lucas S. Blanton
Keyword(s):  
Febrile Illness ◽  
Acute Febrile Illness ◽  
In Vitro Susceptibility ◽  
Rickettsia Species ◽  
Vector Borne

Rickettsia are obligately intracellular vector-borne bacteria that cause acute febrile illness (1).…

scholarly journals Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016

2017 ◽  
Vol 97 (5) ◽  
pp. 1313-1315 ◽  
Author(s):  
Jeromie Wesley Vivian Thangaraj ◽  
Ashok Kumar Pandey ◽  
R. Sabarinathan ◽  
Winsley Rose ◽  
C. P. Girish Kumar ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Uttar Pradesh ◽  
Febrile Illness ◽  
Acute Febrile Illness
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