Scrub Typhus During Pregnancy: A Study from Northeast India

Introduction: Scrub typhus is a crucial underrecognized cause of undifferentiated febrile illness in Northeastern India. Scrub typhus in pregnancy is an uncommon entity. In such cases, not initiating effective and safe antibiotics leads to maternal and fetal complications. To reduce complications, it is a must to keep a high index of clinical suspicion. Methodology: The present study was conducted to find the various disease manifestations of scrub typhus during pregnancy from January 2014 to December 2018. It was a retrospective study that included hospitalized patients with a diagnosis of scrub typhus during pregnancy. The scrub typhus was diagnosed based on the clinical presentation and serological test with Weil-Felix test titer for OXK more or equal to 1:160 or immunochromatographic test positive for scrub typhus IgM antibody. Result: During the study period, complete data were obtained from nine patients. The mean age of the patient was 26.5 years. A maximum of five patients presented in the third trimester, and two presented each in the first and second trimesters. Adverse fetal outcome was found in 33.3% of cases. Two patients had multiorgan dysfunction syndrome, and hepatitis was found to be a common occurrence. Conclusion: Scrub typhus during pregnancy presents a unique problem that is associated with high fetal loss and maternal complications. Keeping a high index of suspicion for diagnosis in endemic regions is essential, as prompt initiation of safe and effective antibiotics can prevent complications.