Scrub Typhus- An Underestimated Infectious Disease Attributable to Community Acquired Acute Kidney Injury

Arpita Paul; Vaishali Sarma; Parasmita Das Choudhury; Gayatri Pegu; Kishore Sarma; Anisha Sarma; Lahari Saikia

doi:10.1007/s12088-023-01137-x

Scrub Typhus- An Underestimated Infectious Disease Attributable to Community Acquired Acute Kidney Injury

Indian J Microbiol. 2024 Mar;64(1):133-140. doi: 10.1007/s12088-023-01137-x. Epub 2023 Dec 1.

Authors

Arpita Paul¹, Vaishali Sarma², Parasmita Das Choudhury², Gayatri Pegu³, Kishore Sarma⁴, Anisha Sarma², Lahari Saikia²

Affiliations

¹ Department of Microbiology, Nagaon Medical College and Hospital, Nagaon, Assam 782003 India.
² Department of Microbiology, Gauhati Medical College and Hospital, Guwahati, Assam 781032 India.
³ Department of Nephrology, Gauhati Medical College and Hospital, Guwahati, Assam 781032 India.
⁴ Department of Zoology, Gauhati University, Guwahati, Assam 781014 India.

PMID: 38468746
PMCID: PMC10924807 (available on 2025-03-01)
DOI: 10.1007/s12088-023-01137-x

Abstract

Acute Kidney Injury (AKI) associated with Scrub typhus is an emerging health problem which is more common in the tropics including India. This study intended to find out the occurrence of Scrub typhus among the Community Acquired Acute Kidney Injury patients in a tertiary care hospital in Assam, North East India. AKI patients with acute febrile illness admitted to Gauhati Medical College and Hospital, Guwahati, Assam were included in the study and demographic characteristics along with clinical features were recorded. The detection of Scrub typhus was done by IgM Enzyme Linked Immunosorbent Assay (ELISA) test (Optical Density > 0.5) and polymerase chain reaction (PCR) analysis. Routine haematological and biochemical tests were performed. Molecular characterization of Orientia tsutsugamushi was done followed by phylogenetic analysis. The Graph Pad Prism software 9 was used for statistical analysis. Out of 221 AKI patients admitted to hospital, 45 patients (20.4%) were confirmed to be Scrub typhus positive and among them, 4 cases were co-infected with leptospirosis. Majority of Scrub typhus positive AKI patients were in Stage I (82.2%) under KDIGO guideline. "Karp" was the predominant circulating serotype. The study showed cases of Scrub typhus associated Acute Kidney Injury was high and mortality was 11.1%. Hence, in this region, further studies need to be done with large number of population and more emphasis need to be given on differential diagnosis.

Supplementary information: The online version contains supplementary material available at 10.1007/s12088-023-01137-x.

Keywords: Acute Kidney Injury; IgM ELISA; Orientia tsutsugamushi; Scrub typhus.

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