Does the presence of an eschar correlate with severity of scrub typhus infection

Background & Materials and Methods:  In scrub typhus (ST) the correlation of disease severity to the presence or absence of eschar is not known. We describe the differences between patients with an eschar and those without.  Results:  In the 193 patients, 105 (56%) had an eschar. Patients with an eschar had a higher incidence of renal failure (18.1% vs. 5.7%; P = 0.01), respiratory system involvement (30.5% vs. 13.6%; P = 0.01) and cardiovascular system (CVS) involvement (21.9% vs. 10.2%; P = 0.03). Involvement of the central nervous system, hematological system and gastro-intestinal tract were not statistically significant between the two groups. ST patients with an eschar had significantly higher requirement for noninvasive ventilation (9.1% vs. 1.9%; P = 0.04). Requirement of invasive ventilation and inotropic supports were the same in both groups.  C onclusion:  The presence of an eschar in patients with ST is associated with a higher incidence of renal dysfunction, CVS and respiratory system involvement and a greater requirement of noninvasive ventilatory support.