Eschar as a Sensitive Marker for Scrub Typhus Diagnosis at the Primary Healthcare Level

Abstract

Background and aim of study: Scrub typhus, a potentially fatal rickettsial disease, is reported from many Indian
states, but mostly from tertiary care centers. This study is distinct as it was undertaken in a primary care center in
a rural area. Aim was to observe the age, gender and occupational profile of patients diagnosed with scrub typhus
at our center during the period from January 2017-19; to find out about the site and day of appearance of eschar
with respect to duration of fever and to note the clinical features and complications of scrub typhus.
Methods: Study sample consisted of patients presenting with fever who developed an eschar and positive serology
for Ig M on the 10th day.
Conclusion: A total of 31cases were seen, of which four were children and eighteen were adult females. The
“eschar” was picked up within 5 days of onset of fever in 26(84%) cases. There was no mortality. This study is
unique also in the large size of the cases from a rural center and short latency to effective treatment. The study
emphasizes the necessity of picking up the eschar by detailed examination in all cases of pyrexia and instituting
early specific treatment.