Hyperuricemia in Scrub Typhus

Hyperuricemia in patients of scrub typhus is associated with severe scrub typhus, according to a recent study published in the Journal of the Association of Physicians of India.

A group of researchers conducted a study to examine the association of hyperuricemia with the severity of scrub typhus. The researchers studied clinical features, laboratory profile, in-hospital course, and outcome of 92 patients of scrub typhus and association of hyperuricemia with the severity of the disease.

Results of the Study

Of the total 92 patients in the study group:

• 66 (71.7%) were females and 26 (28.3%) were males.
• Common clinical features included:
  • Fever (100%)
  • Cough (37%)
  • Headache (33%)
  • Vomiting (31%)
  • Altered sensorium (23%)
  • Diarrhoea (18%)
  • Abdominal pain (16%)
  • Myalgia (14%)
  • Seizures (3%)
• Eschar was present in 23% of patients.
• 34 (37%) patients had hyperuricemia (HU) and 58 patients had normal serum uric acid levels.

The patients of scrub typhus with HU had a significantly higher presentation with altered sensorium (35.3%). In the HU group, mean TLC, mean serum urea, and serum creatinine were higher, and mean serum albumin and mean HDL cholesterol were lower than patients of scrub typhus without hyperuricemia. These differences between the two groups were statistically significant. Neurological dysfunction, severe sepsis, serum creatinine >3.5mg/dL, and involvement of at least a single organ were significantly higher in the HU group. A total of 4 patients (4.3%) died, and all had HU.

Conclusion

Thus, the researchers concluded that hyperuricemia in patients with scrub typhus was associated with severe scrub typhus. The serum uric acid levels should be done in the early course of all patients suffering from scrub typhus. The patients showing hyperuricemia should be monitored closely for early recognition of complications and managed aggressively.

Reference

Is Hyperuricemia a Marker of Severity of Disease in Scrub Typhus? by Sanyam K Mahajan et al. published in the Journal of the Association of Physicians of India.

Read the full study