Journal of vector borne diseases
July 1, 2026 · via Europe PMC
Predictors of mortality in scrub typhus fever: A cross-sectional study from central India.
Singh UP, Mishra DK, Gangwar P, Kushwaha P.
AI summary — for doctors, generated from the abstract only
In a central Indian study of scrub typhus patients, 16% died, with older age, female sex, rural residence, specific symptoms (breathlessness, jaundice, abnormal behavior), and abnormal lab findings (low platelets, high liver enzymes, high creatinine, high CRP) all predicting higher mortality risk, emphasizing the importance of early recognition by primary care physicians.
What was studied
A cross-sectional study of 200 serologically confirmed scrub typhus patients over one year in central India, collecting demographic, clinical, laboratory, and outcome data to identify predictors of in-hospital mortality.
Key findings
- 168 of 200 patients (84%) recovered while 32 (16%) died.
- Mortality was higher in older patients, females, and rural residents; symptoms like breathlessness, jaundice, abnormal behavior, and myalgia were strongly associated with poor outcomes.
- Laboratory findings including thrombocytopenia, elevated liver enzymes, elevated creatinine, and high CRP were significant mortality predictors.
- Major complications included ARDS, renal failure, and liver failure; farming occupation and rural residence also correlated with increased death risk.
Clinical relevance
The findings identify specific clinical and laboratory red flags that primary care physicians and emergency clinicians in scrub typhus-endemic regions can use to identify high-risk patients early and escalate care appropriately, which is directly relevant to improving survival through earlier recognition and targeted management in rural and resource-limited settings where this disease is a significant public health challenge.
Who should care
Limitations
This is a single-region cross-sectional study, which may limit generalizability to other scrub typhus-endemic areas with different healthcare access or patient populations; the abstract text was truncated before giving the exact p-value for the occupation/residence mortality association.
In this central Indian study, 16% of scrub typhus patients died, with specific symptoms and lab abnormalities (thrombocytopenia, elevated liver enzymes, high creatinine, high CRP) predicting mortality, underscoring the critical role of early recognition by primary care physicians in this re-emerging disease.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background objectives
Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi , has re-emerged as a major public health challenge in India, especially in rural and resource-constrained areas. Due to its nonspecific presentation and limited diagnostic access, early diagnosis is often missed, leading to potentially fatal complications like acute respiratory distress syndrome (ARDS), renal failure, liver dysfunction, and encephalopathy. This cross-sectional study aimed to identify clinical and laboratory predictors of mortality in scrub typhus patients and emphasize the vital role of primary care physicians in early diagnosis and management.
Methods
A total of 200 patients with serologically confirmed scrub typhus were enrolled over a one-year period. Detailed demographic, clinical, laboratory, and outcome data were collected and analyzed to determine associations with in-hospital mortality.
Results
Out of 200 patients, 168 (84%) recovered while 32 (16%) died. Mortality was higher in older patients, females, and rural residents. Symptoms like breathlessness, jaundice, abnormal behavior, and myalgia were strongly associated with poor outcomes. Laboratory findings including thrombocytopenia, elevated liver enzymes, creatinine, and high CRP were significant mortality predictors. Major complications included ARDS, renal failure, and liver failure. Farming occupation and rural residence also correlated with increased risk of death (p< 0.01).
Interpretation conclusion
Scrub typhus remains a significant cause of mortality, especially in rural and resource-limited areas. Patients presenting with severe symptoms and abnormal laboratory markers are at higher risk of poor outcomes. Early recognition of these high-risk features by healthcare providers is critical. Prompt and targeted management can significantly improve survival rates.
DOI
10.4103/jvbd.jvbd_148_25
PMID
42574146
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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