DIAGNOSTIC CHALLENGES AND CLINICAL IMPLICATIONS OF PSEUDOTHROMBOCYTOPENIA IN PATIENTS WITH SCRUB TYPHUS

DR.SATHYA. P,DR. YOGALAKSHMI,DR. ISHWARYA DHEVI

Introduction

Scrub typhus, caused by the bacterium Orientia tsutsugamushi, is an acute, febrile illness that poses significant health challenges, particularly in endemic regions of Asia-Pacific. The study aims to elucidate the diagnostic challenges and clinical implications of pseudothrombocytopenia in patients with scrub typhus.

Material and methods

This retrospective observational study was conducted at Saveetha Medical College and Hospital, a tertiary care center in Chennai, India, over a one-year period from June 2023 to June 2024. A total of 200 patient records were reviewed, including those diagnosed with scrub typhus confirmed by serology (IgM ELISA) or polymerase chain reaction (PCR) for Orientia tsutsugamushi and had available complete blood count (CBC) and platelet count data. Inclusion criteria consisted of patients aged 18 years and above with a confirmed diagnosis and available laboratory data. Exclusion criteria included patients with pre-existing hematological disorders, those on medications affecting platelet count or function, and records with incomplete or missing laboratory data.

Results

The study analyzed demographic and clinical characteristics of patients with scrub typhus and other acute febrile illnesses (AFI). Fever was universally present, with high prevalence of myalgia and headache. Pseudothrombocytopenia was more common in scrub typhus (49 cases) than in AFI (29 cases), while true thrombocytopenia was more frequent in AFI (55 cases) compared to scrub typhus (5 cases). Statistical analysis revealed significant differences in platelet count distributions between the groups. The findings highlight the importance of accurately diagnosing pseudothrombocytopenia to avoid unnecessary treatments.

Conclusion

The findings highlight the prevalence of pseudothrombocytopenia in scrub typhus, the need for accurate differentiation from true thrombocytopenia, and the significant differences in platelet count distributions between scrub typhus and other AFIs.