Clinical and biochemical profile of scrub typhus patients with emphasis on liver dysfunction in a tertiary care centre in South Rajasthan

Background: Scrub typhus is a zoonotic infectious disease presenting commonly with acute febrile illness of variable severity and symptoms. It mimics other more prevalent tropical febrile illnesses such as dengue, malaria, and leptospirosis. Prevalence is high in and around Udaipur due to hilly terrains and agricultural farmlands. Multisystem involvement is common but liver dysfunction is a fatal comorbidity. Methods: In a retrospective observational study, we analyzed the clinical, biochemical, and demographic parameters of 85 patients of scrub typhus. The study population was distributed into four groups for abnormal liver chemistries based on American College of Gastroenterology (ACG) clinical guidelines: normal, borderline high, mild elevation, and moderate elevation. Results: Almost 80% of patients had abnormal liver chemistries including either serum bilirubin or transaminases. More than 30% of patients were categorized in group 2 and group 3 of the abnormal liver chemistries. Group 4 with moderate to severe liver dysfunction had 15.3% (n=13) patients. Thrombocytopenia and elevated blood urea and Creatinine were significantly seen in patients with both scrub typhus and liver dysfunction. Conclusions: Thus, in our study prevalence of hepatitis and jaundice with multiorgan failure in scrub typhus patients was significantly high. Timely identification of systemic complications and screening of liver chemistries on presentation is of utmost importance for better outcomes, among seriously ill patients.