What is the clinical evidence from this study?

Study design: Observational. Population: Scrub typhus (n=546). Intervention: Risk factors (diabetes mellitus, skin rash, hemoglobin <7 g/dL). Primary outcome: Severe disease outcomes (OR 4.407, p=0.004).

What does this research mean for the field?

Diabetes mellitus, skin rash, and severe anemia (hemoglobin <7 g/dL) are significant clinical and laboratory predictors of severe scrub typhus outcomes in adults. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 22, 2026Open Access

Clinical and laboratory indicators of severe scrub typhus in adults: Insights from a retrospective study in a teaching hospital in South India

Q: What are the key findings of this study?

Diabetes mellitus (OR 3.206), skin rash (OR 1.888), and hemoglobin <7 g/dL (OR 4.407) were significant predictors of severe scrub typhus outcomes.

Q: What does this research mean for the field?

Diabetes mellitus, skin rash, and severe anemia (hemoglobin <7 g/dL) are significant clinical and laboratory predictors of severe scrub typhus outcomes in adults. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

The aim is to identify clinical and laboratory predictors associated with severe scrub typhus in adults.

Key Result

Diabetes mellitus (OR 3.206), skin rash (OR 1.888), and hemoglobin <7 g/dL (OR 4.407) were significant predictors of severe scrub typhus outcomes.

Key Points

The aim is to identify clinical and laboratory predictors associated with severe scrub typhus in adults.
Conducted a retrospective analysis of scrub typhus patients aged 18 years and above.
Utilized IgM ELISA for diagnosis confirmation.
Statistical tests were used to assess predictors of severe disease outcomes.
44.1% of scrub typhus cases were male, with a mean age of 47.1 years.
High-grade fever (87.9%) and eschar (44.1%) were the most common symptoms.
Diabetes mellitus, skin rash, and hemoglobin <7 g/dL were significant predictors of severity.

Study Design

Type

Observational (n=546)

Multicenter

Structured PICO

What are the clinical and laboratory predictors associated with severe scrub typhus in adults?

Population

546 scrub typhus patients aged 18 years and above admitted to Mahatma Gandhi Hospital, Puducherry, from 2019 to 2023, mean age 47.1 years, 44.1% male.

Outcome

Clinical and laboratory predictors associated with the severity of scrub typhus

Diabetes mellitus, skin rash, and severe anemia are significant predictors of severe scrub typhus in adults, highlighting the need for early recognition to manage complications.

Main Result

Effect estimate: OR 4.407

p-value: p=0.004

Abstract

A BSTRACT Introduction: Scrub typhus, caused by Orientia tsutsugamushi , is a mite-borne infectious disease prevalent in the “tsutsugamushi triangle,” including India. This study analyzes clinical and laboratory characteristics of scrub typhus patients at a tertiary care hospital in Puducherry to improve timely diagnosis, risk assessment, and management of complications. Objective: To identify the clinical and laboratory predictors associated with the severity of scrub typhus in patients admitted to a teaching hospital in Puducherry, South India. Materials and Methods: A retrospective analysis was conducted on scrub typhus patients aged 18 years and above admitted to Mahatma Gandhi Hospital, Puducherry, from 2019 to 2023. IgM ELISA confirmed diagnosis. Statistical tests identified clinical and laboratory predictors associated with severe disease outcomes. Results: Among 546 scrub typhus cases, 44.1% were males and 55.9% females, with a mean age of 47.1 years. High-grade fever (87.9%) and eschar (44.1%) were the most common symptoms. Significant predictors of severity included diabetes mellitus ( P = 0.001; odds ratio OR =3.206), skin rash ( P = 0.030; OR = 1.888), and hemoglobin <7 g/dL ( P = 0.004; OR = 4.407). Conclusion: This study underscores the public health burden of scrub typhus, emphasizing severe complications like myocarditis and pneumonia. Identifying key predictors, such as diabetes, skin rash, and severe anemia, is crucial for early recognition and timely intervention to reduce mortality and manage the disease effectively.