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June 3, 2026Cureus0 citationsOpen Access

Scrub Typhus in the Modern Era: Clinical Spectrum, Organ Involvement, and Outcomes in a South Indian Tertiary Care Setting

RKRevathi KGKGuranjan KaurPJPruthvi J

Key Result

Among 50 adults with scrub typhus, 78% required ICU admission and 24% needed ventilatory support, yet all patients survived with appropriate treatment.

Key Points

  • This study aims to describe the clinical characteristics and outcomes of scrub typhus in patients with positive IgM antibody results.
  • Conducted a prospective hospital-based observational study in Bengaluru from September 2022 to February 2024.
  • Enrolled 50 adult patients with IgM ELISA-confirmed scrub typhus.
  • Collected and analyzed demographic details, clinical features, laboratory parameters, complications, and outcomes.
  • Fever was present in 100% of patients, with myalgia in 66% and gastrointestinal symptoms in 50%.
  • Major complications included acute respiratory distress syndrome in 22%, pneumonia in 20%, and myocarditis in 16%.
  • All patients survived with appropriate treatment, highlighting the importance of early recognition.

Study Design

Type

Observational (n=50)

Multicenter

No

Structured PICO

P
Population
50 adult patients with IgM ELISA-confirmed scrub typhus evaluated at a tertiary care center in Bengaluru, India.
O
Outcome
Clinical characteristics, complications, and outcomes

Scrub typhus presents with significant morbidity and multi-organ involvement, including myocarditis, but has favorable outcomes with early recognition and treatment.

Abstract

Background Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi, is re-emerging in India, with varied clinical presentations and potentially life-threatening complications. However, data from southern India remain limited. Aim This study aimed to describe the clinical characteristics and outcomes of patients diagnosed with scrub typhus based on positive IgM antibody results detected by enzyme-linked immunosorbent assay (ELISA). Methods We conducted a prospective hospital-based observational study at a tertiary care center in Bengaluru from September 2022 to February 2024. Fifty adult patients with IgM ELISA-confirmed scrub typhus were enrolled. Demographic details, clinical features, laboratory parameters, complications, and outcomes were systematically recorded and analyzed. Results The mean age of patients was 50.5 ± 13.2 years, with equal male-to-female distribution (25 (50%) males and 25 (50%) females). Fever was present in 50 (100%) patients, followed by myalgia in 33 (66%) and gastrointestinal symptoms in 25 (50%) patients; eschar was detected in 12 (24%) patients. Laboratory abnormalities included elevated transaminases (AST > 3× upper limit of normal) in 15 (30%) patients, thrombocytopenia (5 mg/dL) in 48 (96%) patients. Major complications included acute respiratory distress syndrome (11, 22%), pneumonia (10, 20%), myocarditis (8, 16%), and acute kidney injury (6, 12%). Intensive care unit (ICU) admission was required in 39 (78%) patients, with ventilatory support required in 12 (24%) patients. All patients survived with appropriate treatment. Conclusion Scrub typhus presents with nonspecific clinical features and significant morbidity due to multi-organ involvement; however, favorable outcomes can be achieved with early recognition and timely treatment. Our findings emphasize the need for heightened clinical suspicion and routine testing for scrub typhus in patients with acute undifferentiated febrile illness in endemic regions.

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Cite This Study

K et al. (2026) conducted an observational in Scrub typhus (n=50). Scrub typhus was evaluated on Clinical characteristics, complications, and outcomes. Among 50 adults with scrub typhus, 78% required ICU admission and 24% needed ventilatory support, yet all patients survived with appropriate treatment.

synapsesocial.com/papers/6a1fc6cddee9eb8c0dce7afahttps://doi.org/10.7759/cureus.110012
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