A study on laboratory features of scrub typhus

R. Ramanathan, E. Yazhini


Background: Rickettsial infections are the most common re-emerging infections in the recent times especially Scrub typhus. If untreated, fatality rate is as high as 30-35%. Scrub typhus can cause changes in hematological and biochemical parameters. The need for this study is to correlate the laboratory investigations in patients with scrub typhus, so that early diagnosis and appropriate treatment can be done.

Methods: This prospective observational study was carried out in children admitted in the pediatric ward/ pediatric ICU of RMMCH who were diagnosed to have Scrub typhus by positive ELISA test. Their basic laboratory investigations are categorized and correlated.

Results: Normal Leukocyte count was seen in 48% (n=24) of the cases, leucocytopenia 30% (n=15), leucocytosis 22% (n=11). Platelets <1.5 lakhs were seen in 72% (n=36) and none of the cases had platelets less than 80000. Hb< 9gm/dl was seen in 44% (n=22). Hyponatremia in 24% (n=12). CRP was positive in 28% (n=14). Hypoalbuminemia was seen in 22% (n=11). Renal function test was normal in all the cases.

Conclusions: This study discusses the various biochemical and hematological changes in patients with Scrub typhus. Pancytopenia is rare in patients with Scrub typhus. Abnormalities in renal and liver function tests may indicate the progression to complications. Normal WBC count with hyponatremia and hypoalbuminemia with related symptoms and signs can be used to diagnose the disease at earlier stages.


Hypoalbuminemia, Hyponatremia, Laboratory investigations, Rickettsia, Scrub Typhus

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