Molecular Detection of Scrub Typhus Using Nested PCR Analysis in Chennai: A Case Report

Scrub typhus is a mite-borne rickettsial zoonosis caused by Orientia tsutsugamushi. We report a case of scrub typhus with Acute Respiratory Distress Syndrome (ARDS) and Diabetic ketoacidosis (DKA) in an adult diabetic male in Chennai. The diagnosis was made initially by serology and subsequently confirmed by detection of the 56 kDa gene. 

___

  • 1. Ha NY, Kim Y, Choi JH, et al. Detection of Antibodies against Orientia tsutsugamushi Sca Proteins in Scrub Typhus Patients and Genetic Variation of sca Genes of Different Strains. Clin Vaccine Immunol 2012; 19(9):1442-1451. 2. Krishna PV, Chepuri VR, Kanumuri S, Yarram R and Yadalla S. A rare case of scrub typhus masquerading as breast abscess. Nitte Univ J Healt Sci 2014; 4:107-9. 3. Sonthayanon P, Chierakul W, Wuthiekanun V, et al. Rapid Diagnosis of Scrub typhus in rural Thailand using Polymerase Chain Reaction. Am. J. Trop. Med Hyg 2006; 75(6):1099-1002. 4. Izzard L, Fuller A, Blacksell SD, et al. Isolation of a Novel Orientia Species (O. chuto sp. nov.) from a Patient Infected in Dubai. J Clin Microbiol 2010; 48 (12):4404-4409. 5. Narvencar KP, Rodrigues S, Nevrekar RP, et al. Scrub typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res 2012; 136:1020-1024. 6. Goswami D, Hing A, Das A, Lyngdoh M. Scrub typhus complicated by acute respiratory distress syndrome and acute liver failure: a case report from Northeast India. Int J Infect Dis 2013; 17 (8):644-645. 7. Sinha P, Gupta S, Dawra R, Rijhawan P. Recent outbreak of scrub typhus in North Western part of India. Indian J Med Microbiol 2014; 32:247-250. 8. Isaac R, Varghese GM, Mathai E, Manjula J, Joseph I. Scrub typhus: Prevalence and diagnostic issues in rural Southern India. India Clin Infect Dis 2004;39:1395-1396. 9. Kanemasa Y, Hamamoto Y, Iwasaki Y, et al. A Case of Diabetic Ketoacidosis Associated with Guillain- Barré Syndrome. Intern Med 2011; 50(19):2201-2205. 10. Singh RBS, Vengadakrishnan K, Damodharan J. A Case Report of Scrub Typhus with ARDS in Pregnancy. Int J Emerg Trends Sci Technol 2015; 14(1):14-16 11. Saxena A, Khiangte B, Tiewsoh I. Scrub Typhus Complicated by Acute Respiratory Distress Syndrome and Multiorgan Failure; an Unrecognized Alarming Entity in Central India: A Report of Two Cases. J Family Med Prim Care 2014; 3(1):80-83.