Scrub typhus

1,193 views

Published on

Published in: Health & Medicine, Technology
  • Be the first to comment

Scrub typhus

  1. 1. SCRUB TYPHUS Tsutsugamushi Disease
  2. 2. Contents Distribution Epidemiological determinants Mode of Transmission Clinical Features Investigations Complications Management Prognosis Prevention
  3. 3. INFECED REGIONS
  4. 4.  First in Japan  First in India during world war II  Common among millitants
  5. 5. Epidemiological determinants Agent: Orientia tsutsugamushi. Reservoir: Trombiculid mite. Leptotrombidium deliensis- India. Leptotrombidium akamushi- Japan.
  6. 6. Chigger reservoir Larval stage vector
  7. 7. Mode of Transmission Mite Rats & Mice Humans Mite   No direct person to person transmission Mite Islands (Accidental host)
  8. 8. Clinical Features  Incubation peroid: 1-3 wks(usually6-21 days)  Fever(104-105°F) with chills,malaise,conjunctival Irritation.  Maculopapular rash  Lymphadenopathy,Lymphocytosis  Headache, Cough, Myalgia  Gastrointestinal symptoms  Typical “Eschar formation”(5th day of illness)
  9. 9. Punched out lesions with black scab
  10. 10. Investigations • Weil-feilx test positive-proteus strain oxk • Indirect immunofluorescence. • PCR for Orientia tsutsugamushi from blood of feverish patients. • Some studies have used PCR (polymerase chain reaction) on specimens obtained from eschars.
  11. 11. Complications  Pneumonitis  Hepatitis  Myocarditis  Meningoencephalitis  Disseminated intravascular coagulation  Multi organ failure
  12. 12. Management • Drug of choice: Tetracycline Doxycycline orally or Chloramphenicol in more severe cases. Azithromycin has been used in resistant cases and may be better than doxycycline - especially in children and pregnant women.
  13. 13. Prognosis  Fatality of untreated cases is between 5 - 10 % and is even higher in adults.
  14. 14. PreventionVector control:  Application of insecticides eg: lindane or chlordane to ground and vegetation.  Environmental control  Personal protection
  15. 15. Thank you

×