COMPLICATIONS SEEN IN RICKETTSIAL INFECTION

Dr. Nisha Davy Olakkengil*

ABSTRACT

Introduction: Rickettsial fever is a major health concern in different districts of Karnataka with serious complications, including morbidity and mortality, if diagnosed late. Hence with timely diagnosis optimum treatment and adequate care can be ensured. In this study we will be looking into detail regarding the complications associated with rickettsial infection if not diagnosed and treated at the right time. Some of the complications include acute renal failure, ARDS, thromboctyopenia with bleeding and pleural effusion with the latter being the most common. Objectives: To study the, complications seen in patients with rickettsial infections. Methods: This is a prospective observational study done from June 2019 to February 2020, Bengaluru, Karnataka, India. Weil Felix positive patients with four fold rise in titres were considered. Results: A total of 394 patients of Acute Febrile Illness were admitted during the study period. A total of 47cases(11.92%)were tested positive for rickettsia, out of which scrub typhus was the commonest 33 (72%). Most patients presented in the months of July -October. Weil Felix positive patients with four fold rise in titres were considered. 86%of the patients belonged to rural areas and most of them were farmers by occupation. Age group involved being 20 – 30 years. Males(56.2%) were affected more than females(43.17%) Fever(100%) was the complaint seen in all patients with rickettsial infection. They also had complaints like myalgia (86%), headache(79%),cough(31%),vomiting (34%), joint pain (30%),abdominal pain (19%) and diarrhoea (10%) Thrombocytopenia was in70% of the patients. When emphasis was given to scrub typhus(72%), the most common variant it was found 51%had splenomegaly,18%macular rash,16%hepatomegaly, 7%icterus, 7% lymphadenopathy and 1%eschar. Complications like pleural effusion was seen in 20%, non oliguric ARF(9%), ARDS(10%), liver cell failure (2%) and thrombocytopenia with bleeding (2%). Conclusion: Rickettsial infection is one of the most common causes of acute febrile illness. Due to its non specific signs and symptoms it should be considered in the differential of acute febrile illness. As the number of rickettsial cases have increased considerably well targeted history and clinical examination will aid in early diagnosis and prevent complications due to delayed diagnosis.

Keywords: Complications, weil felix, thrombocytopenia.