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Anand AC, Praharaj D. Acute hepatitis in tropics: A rainbow of causes. Indian J Gastroenterol 2023; 42:308-310. [PMID: 37300795 DOI: 10.1007/s12664-023-01403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Anil C Anand
- Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, 751 024, India.
| | - Dibyalochan Praharaj
- Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, 751 024, India
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Parai D, Pattnaik M, Kshatri JS, Rout UK, Peter A, Nanda RR, Sahoo SK, Mansingh A, Choudhary HR, Dash GC, Praharaj I, Bhattacharya D, Pati S. Scrub typhus seroprevalence from an eastern state of India: findings from the state-wide serosurvey. Trans R Soc Trop Med Hyg 2023; 117:22-27. [PMID: 35947959 DOI: 10.1093/trstmh/trac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/30/2022] [Accepted: 07/29/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Scrub typhus is a mite-borne infectious disease caused primarily by the obligate intracellular bacteria Orientia tsutsugamushi, which is transmitted by chigger mites. The objective of this study was to determine the prevalence of scrub typhus among adults in Odisha, an eastern state of India. METHODS A descriptive cross-sectional study was conducted to analyse 1840 serum samples from five districts (Khordha, Cuttack, Ganjam, Malkangiri and Sundargarh) of Odisha collected during 2020-2021. Both immunoglobulin G (IgG) and IgM antibodies against scrub typhus were tested using commercial enzyme-linked immunosorbent assay kits. Point estimates of the 95% confidence interval and adjusted odds ratio were calculated. RESULTS Of 1840 participants, the prevalence of IgG positivity was 1034 (56.19%) and that of IgM was 523 (28.42%). The majority of participants were in the 18-45 y age group (53.7%). Cuttack had the highest IgG positivity (64.54%) and Malkangiri had the lowest (29.32%). The highest and lowest positivity for IgM were found in Malkangiri (40.84%) and Cuttack (25.30%), respectively. CONCLUSIONS With an increasing number of infections detected in the state, scrub typhus is emerging as a public health threat. Increasing awareness among the general public and healthcare professionals through health education campaigns regarding scrub typhus is essential. Early detection of the disease through the establishment of a laboratory surveillance system is required to control the transmission of scrub typhus.
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Affiliation(s)
- Debaprasad Parai
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Matrujyoti Pattnaik
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Jaya Singh Kshatri
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Usha Kiran Rout
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Annalisha Peter
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Rashmi Ranjan Nanda
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Subrat Kumar Sahoo
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Asit Mansingh
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Hari Ram Choudhary
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Girish Chandra Dash
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Ira Praharaj
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Debdutta Bhattacharya
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
| | - Sanghamitra Pati
- Department of Microbiology, Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, India
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Imad HA, Ali AA, Nahuza M, Gurung R, Ubaid A, Maeesha A, Didi SA, Dey RK, Hilmy AI, Hareera A, Afzal I, Matsee W, Nguitragool W, Nakayama EE, Shioda T. Acalculous Cholecystitis in a Young Adult with Scrub Typhus: A Case Report and Epidemiology of Scrub Typhus in the Maldives. Trop Med Infect Dis 2021; 6:tropicalmed6040208. [PMID: 34941664 PMCID: PMC8707333 DOI: 10.3390/tropicalmed6040208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/21/2022] Open
Abstract
Scrub typhus is a neglected tropical disease predominantly occurring in Asia. The causative agent is a bacterium transmitted by the larval stage of mites found in rural vegetation in endemic regions. Cases of scrub typhus frequently present as acute undifferentiated febrile illness, and without early diagnosis and treatment, the disease can develop fatal complications. We retrospectively reviewed de-identified data from a 23-year-old woman who presented to an emergency department with complaints of worsening abdominal pain. On presentation, she appeared jaundiced and toxic-looking. Other positive findings on abdominal examination were a positive Murphey’s sign, abdominal guarding and hepatosplenomegaly. Magnetic resonance cholangiopancreatography demonstrated acalculous cholecystitis. Additional findings included eschar on the medial aspect of the left thigh with inguinal regional lymphadenopathy. Further, positive results were obtained for immunoglobulins M and G, confirming scrub typhus. The workup for other infectious causes of acute acalculous cholecystitis (AAC) detected antibodies against human herpesvirus 4 (Epstein–Barr virus), suggesting an alternative cause of AAC. Whether that represented re-activation of the Epstein–Barr virus could not be determined. As other reports have described acute acalculous cholecystitis in adult scrub typhus patients, we recommend doxycycline to treat acute acalculous cholecystitis in endemic regions while awaiting serological confirmation.
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Affiliation(s)
- Hisham Ahmed Imad
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan; (E.E.N.); (T.S.)
- Correspondence: or ; Tel.: +66-631501402
| | - Aishath Azna Ali
- Department of Surgery, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.A.A.); (M.N.); (R.G.); (A.U.)
| | - Mariyam Nahuza
- Department of Surgery, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.A.A.); (M.N.); (R.G.); (A.U.)
| | - Rajan Gurung
- Department of Surgery, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.A.A.); (M.N.); (R.G.); (A.U.)
| | - Abdulla Ubaid
- Department of Surgery, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.A.A.); (M.N.); (R.G.); (A.U.)
| | - Aishath Maeesha
- Department of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.M.); (S.A.D.); (R.K.D.); (A.I.H.)
| | - Sariu Ali Didi
- Department of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.M.); (S.A.D.); (R.K.D.); (A.I.H.)
| | - Rajib Kumar Dey
- Department of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.M.); (S.A.D.); (R.K.D.); (A.I.H.)
| | - Abdullah Isneen Hilmy
- Department of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, Maldives; (A.M.); (S.A.D.); (R.K.D.); (A.I.H.)
- Gastrointestinal Unit, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town 7935, South Africa
| | - Aishath Hareera
- Health Protection Agency, Ministry of Public Health, Malé 20002, Maldives; (A.H.); (I.A.)
| | - Ibrahim Afzal
- Health Protection Agency, Ministry of Public Health, Malé 20002, Maldives; (A.H.); (I.A.)
| | - Wasin Matsee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Wang Nguitragool
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Emi. E. Nakayama
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan; (E.E.N.); (T.S.)
| | - Tatsuo Shioda
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan; (E.E.N.); (T.S.)
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