Jang et al reported risk factors for severe scrub typhus in an older adult. These can help to identify a patient who may benefit from more aggressive management. The authors are from Chonnam National University Hospital in South Korea.
Patient selection: age > 65 years AND scrub typhus
Risk factors for severe scrub typhus:
(1) WBC count > 10,000 per µL (odds ratio 2.6)
(2) eGFR < 60 mL per min (using MDRD; odds ratio 3.5)
(3) serum albumin <= 3.0 g/dL (odds ratio 5.0)
(4) APACHE II score on admission > 10 points (odds ratio 3.3)
Risk factors for complications:
(1) severe scrub typhus
(2) delay in diagnosis
(3) delay in appropriate treatment
Complications include:
(1) acute kidney injury
(2) mental confusion
(3) dyspnea
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