Scrub Typhus in Adults – A Case Series from a Tertiary Care Hospital

Objective: Our hospital, tertiary care hospital in the capital of the state of Odisha, had been witnessing pyrexia of unknown origin, associated with breathlessness, renal, and liver impairment, which did not respond to high antibiotics but to doxycycline; therefore, the present study was undertaken to identify whether scrub typhus is the etiological agent, and thereafter, their characteristic features were further evaluated as an effort in supporting its diagnoses and treating patients accordingly.Methods: A total of 65 adult patients (age >15 years) admitted with pyrexia between April 2015 and October 2017 were evaluated. Immunoglobulin M (IgM) scrub typhus test was done in all these patients. IgM scrub typhus test positive samples were included in the study and various clinical parameters analyzed.Results: Of the 65 patients included in the study, all were found to be positive for IgM antibodies against Orientia tsutsugamushi. The cases were seen mainly in the months between September and November. The common symptoms found were fever, myalgia, breathlessness, rash, and abdominal pain and rarely altered sensorium. The diagnostic features like eschar were found in 23% patients. Nearly, two-thirds of patients had fever more than 7 days and myalgia (76.92%), headache (58.46%). The most common complications were renal failure (20%) followed by pneumonia (10.76%). Laboratory findings of high C-reacting protein (89.23%) and leukocytosis are found in 35.38%.Conclusion: Our results showed that scrub typhus should be considered in the differential diagnosis of pyrexia of unknown origin associated with breathlessness, myalgia, rash, gastrointestinal symptoms, hepatorenal syndrome, or acute respiratory distress syndrome. Empirical treatment with doxycycline may be given in the cases with strong suspicion of scrub typhus.

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Case series of paediatric adnexal torsion: rare yet urgent entity

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164685 ◽

2016 ◽

Vol 6 (1) ◽

pp. 315 ◽

Cited By ~ 1

Author(s):

Vineet Mishra ◽

Shaheen Hokabaj ◽

Priyankur Roy ◽

Rohina Aggarwal ◽

Bhumika Vyas ◽

...

Keyword(s):

Ovarian Function ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Conservative Surgery ◽

Paediatric Population ◽

Ovarian Torsion ◽

Care Hospital ◽

Paediatric Age ◽

High Degree

Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

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Awake fiberoptic intubation in patients of deep neck infections: experience at rural tertiary care hospital: case series

International Journal of Medical Science and Public Health ◽

10.5455/ijmsph.2017.05072016577 ◽

2016 ◽

Vol 5 (12) ◽

pp. 2629

Author(s):

Roshan Shende ◽

Shital Mankar ◽

Durgesh Deshmukh ◽

Damodar Patwardhan

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Fiberoptic Intubation ◽

Care Hospital ◽

Hospital Case ◽

Deep Neck Infections ◽

Awake Fiberoptic Intubation

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Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

Journal of the Pakistan Medical Association ◽

10.47391/jpma.10-1016 ◽

2020 ◽

pp. 1-8

Author(s):

Saima Kanwal ◽

Sara Sajid ◽

Noreen Nasir ◽

Syed Ahsan ◽

Aysha Almas

Keyword(s):

Hospital Mortality ◽

Hospital Admissions ◽

Tertiary Care Hospital ◽

Heat Stroke ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Related Factors ◽

Hospital Perspective ◽

The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...

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