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Frequency and distribution of eschar in patients with scrub typhus in India: systematic review of literature and meta-analysis.
Gupta, Nitin; Kumar, Tirlangi Praveen; Boodman, Carl; Fontaine, Kim; Bottieau, Emmanuel.
Afiliación
  • Gupta N; Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
  • Kumar TP; University of Antwerp, Antwerp, Belgium.
  • Boodman C; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
  • Fontaine K; Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
  • Bottieau E; University of Antwerp, Antwerp, Belgium.
Infez Med ; 32(3): 312-322, 2024.
Article en En | MEDLINE | ID: mdl-39282546
ABSTRACT

Introduction:

Scrub typhus is a mite-borne tropical febrile illness with high mortality if untreated. The presence of eschar is pathognomonic, but a wide range of frequencies of eschar positivity has been reported in Indian patients. Therefore, this systematic review and meta-analysis aimed to ascertain the frequency (overall and geographic region-wise) and anatomical distribution of eschar in scrub typhus in India.

Methodology:

We searched articles in two databases using [(scrub OR typhus OR Orientia) AND (eschar) AND (India)]. The articles were independently screened and critically appraised by two authors. The frequency and distribution of eschar in patients with scrub typhus were pooled using a random-effect model.

Results:

After the title-abstract and full-text screening, 107 articles (34002 cases of scrub typhus) were finally included. The overall pooled proportion of eschar positivity was 28.5% (95% CI 24.1 to 32.9%). The pooled eschar positivity varied from ≤12% in Haryana, Rajasthan, Madhya Pradesh, Punjab, and Meghalaya to ≥46% in Tamil Nadu and Tripura. The pooled proportion of eschar positivity in the 'trunk' (39.3%), 'groin' (23.8%), and 'axilla' (16.5%) was higher than in the 'limbs' (9.9%) and 'head' (11.3%).

Conclusion:

Eschar is reported in less than a third of the patients with scrub typhus in India. Most eschars were in the groin, axilla, and the trunk. There is a need to create awareness amongst physicians of the need for thorough physical examination.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infez Med Asunto de la revista: ALERGIA E IMUNOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infez Med Asunto de la revista: ALERGIA E IMUNOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Italia