Pattern of Liver Function Test in Scrub Typhus Cases: A Hospital Based Observational Study in a Tertiary Care Center in Nepal

Abstract

Background and Aim: Scrub typhus, a potentially severe but treatable infection is a major cause of acute non-malarial febrile illness in children in the rural tropics. The present study aims to explore the association between the liver function tests in the cases of scrub typhus and correlate the levels of these parameters with the severity of the scrub typhus infections, their clinical risk characteristics that may be used to forecast disease severity under routine clinical practice. Methodology: This prospective observational study, conducted at National Medical College Teaching Hospital, a tertiary care referral teaching hospital situated in province two of Nepal over a period of 7 months (November, 2021- May 2022) enrolled 75 scrub typhus cases and their liver function tests were done following standard guidelines. Results:There were deranged liver function tests in the participants. The mean Aspartate Transaminase, Alanine Transaminase, Total Bilirubin and Albumin were425.48 ± 505.56 U/L, 368.54 ± 402.22 U/L, 3.8 ± 3.1 mg/dL and 3.10 ± 0.8 g/dL, respectively. Most of the cases presented with hypoalbuminemia (66.7%), cardiac dysfunction (64%), acute kidney injury (61%) and hepatitis (60%). About 9 % of the subjects presented as multiorgan dysfunction syndrome (MODS). Conclusion: Scrub typhus cases presents with deranged liver function tests results and the values can be helpful in assessment of the disease severity and outcome.