SCRUB TYPHUS IN PREGNANCY IN NORTHERN INDIA: A CASE SERIES

Background: Scrub typhus, mite borne intra cellular infection caused by gram-negative coccobacillus Orientia Tsutsugamushi is uncommon in pregnancy. In infected, the presentation can vary from mild asymptomatic to severe unrecognised cause of maternal and fetal death in pregnancy, with case fatality as high as 30%.

Objective: To analyse the outcome of scrub typhus in pregnancy in Northern India.

Material and methods: Pregnant females presented to K.D. Medical College Hospital, Mathura between August 2023- October 2023, with acute undifferentiated febrile illness of ≥5 days duration, were included in this study. Scrub typhus was diagnosed using serum IgM levels by ELISA (IgM Optical Density >0.5). The antenatal and postnatal data of Pregnant females diagnosed and treated with Scrub typhus was reviewed, analysed, and presented as Case series.

Results: Scrub typhus was diagnosed in 8 Pregnant females, 5 of them presented in third trimester while other 3 in second trimester. 37.5% (3) pregnant females had eschar at presentation. 37.5% (3) pregnant females were critically ill requiring ICU admission, one of them had preterm, IUD and abortion respectively, and no maternal mortality was observed.

Conclusion: It is concluded that Scrub typhus in Pregnant females is associated with poor maternal and fetal outcome. Strong suspicion, early diagnosis, and treatment can improve the outcome.