Key result
Among 174 hospitalized patients with scrub typhus and acute kidney injury, the mortality rate was 16.1%, with age, specific laboratory abnormalities, and complications associated with non-survival.
Observational (n=174)
No
AKI is a common and severe complication of scrub typhus, with a 16.1% mortality rate driven by multi-organ involvement and severe biochemical abnormalities.
Scrub typhus-associated AKI warrants close monitoring for multiorgan failure; observational data leaves optimal interventions open for prospective study.
OBJECTIVE: To report the clinical profile of acute kidney injury (AKI) associated with scrub typhus. METHODS: Retrospective study of hospitalized patients of acute febrile illness who were diagnosed scrub typhus and had AKI. RESULTS: 174 (35%) patients (75.9% female), mean age (41.4 ± 15.9 years) were studied. The laboratory abnormalities were: anemia (63.2%), leukocytosis (44.3%), thrombocytopenia (61.5%), hyponatremia (35.6%), hypernatremia (2.9%), and hypokalemia (12.1%), hyperkalemia (11.5%), hypoalbuminemia (56.9%), hepatic dysfunction (70%) and metabolic acidosis (28.7%). The complications of hypotension (5.7%), septic shock (3.4%), pneumonia (10.9%), acute respiratory distress syndrome (ARDS) (11.5%), meningoencephalitis (6.9%), encephalopathy (5.2%), gastrointestinal bleed (1.3%), myocarditis (3.4%), disseminated intravascular coagulation (2.9%) and multi organ failure (MOF) (10.3%) developed during course of hospitalization in these patients. Twenty-five (14.4%) patients required intensive care support (ICU) support and seven (4%) patients were dialyzed. 146 (83.9%) patients survived. Twenty-eight (16.1%) patients died. There was a significant difference in the age, various hematological & biochemical abnormalities, complications and need for ICU support in the non-survival group as compared the survival group. CONCLUSION: This study shows that AKI in scrub typhus is common and a severe disease. Age, a shorter hospital stay, severities of leukocytosis, thrombocytopenia, azotemia, hypoalbuminemia, hepatic dysfunction and the complications of ARDS, encephalopathy, MOF and need for ICU support are the factors associated with mortality.
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Vikrant et al. (2013) conducted an observational in Scrub typhus associated acute kidney injury (n=174). Scrub typhus with acute kidney injury was evaluated on Mortality. Among 174 hospitalized patients with scrub typhus and acute kidney injury, the mortality rate was 16.1%, with age, specific laboratory abnormalities, and complications associated with non-survival.
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