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J Assoc Physicians India. 2019 Mar;67(3):26-27.

Early Clinical Suspicion and Early Use of Doxycycline Reduces Scrub Typhus Associated Complications.

Author information

Professor, IGMC, Shimla, Himachal Pradesh.
Medical Specialist, CH, Sunni, Shimla, Himachal Pradesh,Corresponding Author.
Assistant Professor, IGMC, Shimla, Himachal Pradesh.



Scrub typhus has emerged as an important cause of febrile illness in this Himalayan region of the country. However, it is under considered in the differential diagnoses of febrile illnesses and is not treated and thus, patients often land up with complications in this tertiary care hospital.


It was a retrospective observational study done in department of Medicine from august 2013 to October 2013. All the patients more than or equal to 18 yrs of age admitted during this period with scrub typhus were analysed and their outcome followed. S. ELISA was used to detect scrub typhus.


Total of 106 patients were observed out of which only 10 patients had received anti scrub antibiotics (doxycycline or azithromycin) prior to admission. Seven patients died (6.6%) and none had received anti scrub antibiotics prior to hospitalisation and presented late with average duration of illness of 9.2 days and had more severe form of complications at presentation.Those patients who had received prior anti scrub treatment had fewer and mild complications and none died among that group.


Doxycycline or azithromycin (pregnancy or in child <8 years) should be included in the initial empirical antimicrobial therapy in febrile patients during tick season to treat scrub typhus. The goal is to begin anti-scrub therapy early to reduce the morbidity and mortality associated with this illness.

[Indexed for MEDLINE]

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