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Immune thrombocytopenia with multi-organ dysfunction syndrome as a rare presentation of scrub typhus: a case report

Overview of attention for article published in BMC Research Notes, October 2017
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Title
Immune thrombocytopenia with multi-organ dysfunction syndrome as a rare presentation of scrub typhus: a case report
Published in
BMC Research Notes, October 2017
DOI 10.1186/s13104-017-2826-z
Pubmed ID
Authors

Abraham M. Ittyachen, Saramma P. Abraham, Smitha Krishnamoorthy, Anuroopa Vijayan, Jayamohan Kokkat

Abstract

Scrub typhus is an acute infectious illness caused by Orientia tsutsugamushi. It is endemic to a part of the world known as the "tsutsugamushi triangle". Humans are accidental hosts in this zoonotic disease. About a third of patients admitted with scrub typhus have evidence of multi-organ dysfunction. Multi-organ dysfunction secondary to scrub typhus carries a high mortality rate. We report a 65-year old lady who was admitted in a Tertiary Care Center in the state of Kerala in India, with 7 day history of fever, myalgia and reduced urine output. Head to foot examination revealed the presence of an eschar on her chest. One week prior to the onset of her illness she had gone trekking through a hilly forest area. She was clinically suspected to have scrub typhus, which was later confirmed with laboratory tests. She developed multi-organ dysfunction syndrome secondary to this illness. Though there was an improvement in the multi-organ dysfunction, thrombocytopenia alone failed to improve. Bone marrow study was done which was suggestive of immune thrombocytopenia. Patient was given a course of steroids with which the thrombocytopenia improved. Failure of platelet count to normalize even after there has been a general improvement of other markers of multi-organ dysfunction in scrub typhus should prompt the clinician to consider other potential causes of thrombocytopenia. An unusual finding as this calls for further research to understand the molecular mechanisms behind such an event. Further, considering the close similarity in clinical presentation of several tropical illnesses, meticulous history taking and a detailed physical examination needs to be emphasized.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 9 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 33%
Student > Ph. D. Student 1 11%
Other 1 11%
Student > Master 1 11%
Librarian 1 11%
Other 0 0%
Unknown 2 22%
Readers by discipline Count As %
Biochemistry, Genetics and Molecular Biology 2 22%
Agricultural and Biological Sciences 2 22%
Arts and Humanities 1 11%
Environmental Science 1 11%
Medicine and Dentistry 1 11%
Other 0 0%
Unknown 2 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 October 2017.
All research outputs
#7,428,788
of 11,923,653 outputs
Outputs from BMC Research Notes
#1,346
of 2,637 outputs
Outputs of similar age
#155,721
of 274,783 outputs
Outputs of similar age from BMC Research Notes
#26
of 44 outputs
Altmetric has tracked 11,923,653 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,637 research outputs from this source. They receive a mean Attention Score of 4.5. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 274,783 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 44 others from the same source and published within six weeks on either side of this one. This one is in the 29th percentile – i.e., 29% of its contemporaries scored the same or lower than it.