ReviewLe infezioni in medicina2024
Frequency and distribution of eschar in patients with scrub typhus in India: systematic review of literature and meta-analysis.
Review in Le infezioni in medicina, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Differentiating Spotted Fever From Scrub Typhus Based on Clinical and Laboratory Features: A Retrospective Cohort Study From South India.Open forum infectious diseases · 2026Article
- Clinical and laboratory indicators of severe scrub typhus in adults: Insights from a retrospective study in a teaching hospital in South India.Journal of family medicine and primary care · 2026Article
- Advancing the diagnosis of scrub typhus with targeted next-generation sequencing.Frontiers in microbiology · 2026Article
- Eschar is not the sole clue for scrub typhus: a retrospective analysis of pediatric scrub typhus without eschars.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Scrub Typhus in Kerala: Demographic, Clinical, and Laboratory Predictors of ICU Admission in a Tertiary Care Setting.Le infezioni in medicina · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Scrub typhus is a mite-borne tropical febrile illness with high mortality if untreated. The presence of eschar is pathognomonic, but a wide range of frequencies of eschar positivity has been reported in Indian patients. Therefore, this systematic review and meta-analysis aimed to ascertain the frequency (overall and geographic region-wise) and anatomical distribution of eschar in scrub typhus in India. Methodology: We searched articles in two databases using: [(scrub OR typhus OR Orientia) AND (eschar) AND (India)]. The articles were independently screened and critically appraised by two authors. The frequency and distribution of eschar in patients with scrub typhus were pooled using a random-effect model. Results: After the title-abstract and full-text screening, 107 articles (34002 cases of scrub typhus) were finally included. The overall pooled proportion of eschar positivity was 28.5% (95% CI: 24.1 to 32.9%). The pooled eschar positivity varied from ≤12% in Haryana, Rajasthan, Madhya Pradesh, Punjab, and Meghalaya to ≥46% in Tamil Nadu and Tripura. The pooled proportion of eschar positivity in the 'trunk' (39.3%), 'groin' (23.8%), and 'axilla' (16.5%) was higher than in the 'limbs' (9.9%) and 'head' (11.3%). Conclusion: Eschar is reported in less than a third of the patients with scrub typhus in India. Most eschars were in the groin, axilla, and the trunk. There is a need to create awareness amongst physicians of the need for thorough physical examination.
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