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Serodiagnosis of Scrub typhus in patients attending tertiary care hospital

RAJESWARI J

Abstract


Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, transmitted to humans by bite of the larva of trombiculid mites. It causes a disseminated vasculitis and perivascular inflammatory lesions leading to significant vascular leakage and end-organ failure. Eschar is a                   pathognomic sign of scrub typhus. This study was conducted for early diagnosis of scrub typhus by serological test, and reduce the chances of life threatening complications and to guide             optimal therapy. Aim of the study - To detect the IgM antibodies against Orientia tsutsugamushi (O. tsutsugamushi ) by IgM  Capture Enzyme linked immuno sorbent assay (ELISA) and Weil Felix agglutination test and to compare the results of Weil Felix with ELISA test. Material and Methods - 50 serum samples were collected from the patients with symptoms of undiagosed acute febrile illness The study was conducted at Institute of Microbiology, Madras Medical College and Rajiv Gandhi           Government General Hospital, Chennai-3, between September 2014 and December 2014, were evaluated. Testing was done by using a commercial IgM Capture ELISA kit and Proteus  mirabilis OXK antigen by Weil Felix agglutination test for            detection of antibodies against Orientia tsutsugamushi and to compare the result of ELISA and Weil Felix agglutination test. Results - Totally fifty cases were included in this study. Of which 27 (54 percentage) were male patients and 23 (46 percentage) were female patients. IgM capture ELISA and Weil Felix           agglutination test were performed in all fifty cases. ELISA was positive in twenty six (26, 52 percentage) cases and negative in twenty four (24, 48 percentage) cases. Weil Felix agglutination test was positive in fourteen (14cases, 28 percentage) of ELISA positive cases and negative in 36 cases (72 percentage).           Conclusion - The Scrub typhus is one of the differential              diagnosis of the acute febrile illness. It causes important            complications like renal failure, liver failure, ARDS, MODS,  meningitis and thrombocytopenia. Early diagnosis by clinical examinations and by serological test can reduce the morbidity and mortality.

 


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References


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