Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border

Introduction: Scrub typhus is endemic in rural Southeast Asia. The district of Umphang in northwestern Thailand is a prototype environment for this disease. We report the clinical manifestations and outcomes of patients diagnosed with scrub typhus in this area. Methodology: Patients diagnosed wi...

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Main Authors: Tobias Brummaier, Chatporn Kittitrakul, Vorada Choovichian, Saranath Lawpoolsri, Chayadol Namaik-larp, Yupaporn Wattanagoon
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2017-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/8912
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author Tobias Brummaier
Chatporn Kittitrakul
Vorada Choovichian
Saranath Lawpoolsri
Chayadol Namaik-larp
Yupaporn Wattanagoon
author_facet Tobias Brummaier
Chatporn Kittitrakul
Vorada Choovichian
Saranath Lawpoolsri
Chayadol Namaik-larp
Yupaporn Wattanagoon
author_sort Tobias Brummaier
collection DOAJ
description Introduction: Scrub typhus is endemic in rural Southeast Asia. The district of Umphang in northwestern Thailand is a prototype environment for this disease. We report the clinical manifestations and outcomes of patients diagnosed with scrub typhus in this area. Methodology: Patients diagnosed with scrub typhus between 2011 and 2014 were analyzed. Diagnosis was based on clinical symptoms in conjunction with a positive rapid test or a pathognomonic eschar lesion. Results: A total of 857 patients were included, of which 488 were adults and 369 were children. Most patients (728; 84.9%) were included via a positive serology on rapid test, 86 patients (10.0%) had eschar only, and 43 patients (5.0%) had both sero-confirmation and presence of eschar. The most common symptom was fever (93.8%), followed by headache (48.1%) and cough (33.1%). Eschars were reported in 129 patients, with a significantly higher percentage in children (p < 0.001), and a different anatomical distribution was found when adults and children were compared. Common complications were elevated transaminases, acute kidney injury, and pneumonia. Most patients recovered from the disease. Conclusions: Scrub typhus in Umphang district is common. Patients can present with a variety of clinical symptoms, regardless of the presence of fever. Standard treatment led to a favorable outcome in most patients.
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spelling doaj-art-a1b2e377f42644fd8ebb11438d915ded2025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802017-06-01110510.3855/jidc.8912Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar borderTobias Brummaier0Chatporn Kittitrakul1Vorada Choovichian2Saranath Lawpoolsri3Chayadol Namaik-larp4Yupaporn Wattanagoon5Mahidol University, Bangkok, ThailandMahidol University, Bangkok, ThailandMahidol University, Bangkok, ThailandMahidol University, Bangkok, ThailandUmphang Hospital, Umphang, ThailandMahidol University, Bangkok, Thailand Introduction: Scrub typhus is endemic in rural Southeast Asia. The district of Umphang in northwestern Thailand is a prototype environment for this disease. We report the clinical manifestations and outcomes of patients diagnosed with scrub typhus in this area. Methodology: Patients diagnosed with scrub typhus between 2011 and 2014 were analyzed. Diagnosis was based on clinical symptoms in conjunction with a positive rapid test or a pathognomonic eschar lesion. Results: A total of 857 patients were included, of which 488 were adults and 369 were children. Most patients (728; 84.9%) were included via a positive serology on rapid test, 86 patients (10.0%) had eschar only, and 43 patients (5.0%) had both sero-confirmation and presence of eschar. The most common symptom was fever (93.8%), followed by headache (48.1%) and cough (33.1%). Eschars were reported in 129 patients, with a significantly higher percentage in children (p < 0.001), and a different anatomical distribution was found when adults and children were compared. Common complications were elevated transaminases, acute kidney injury, and pneumonia. Most patients recovered from the disease. Conclusions: Scrub typhus in Umphang district is common. Patients can present with a variety of clinical symptoms, regardless of the presence of fever. Standard treatment led to a favorable outcome in most patients. https://jidc.org/index.php/journal/article/view/8912scrub typhusScrub TyphusescharEscharresource-limitedResource-limited
spellingShingle Tobias Brummaier
Chatporn Kittitrakul
Vorada Choovichian
Saranath Lawpoolsri
Chayadol Namaik-larp
Yupaporn Wattanagoon
Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
Journal of Infection in Developing Countries
scrub typhus
Scrub Typhus
eschar
Eschar
resource-limited
Resource-limited
title Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
title_full Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
title_fullStr Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
title_full_unstemmed Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
title_short Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
title_sort clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the thailand myanmar border
topic scrub typhus
Scrub Typhus
eschar
Eschar
resource-limited
Resource-limited
url https://jidc.org/index.php/journal/article/view/8912
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