Journal of Postgraduate Medicine
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Year : 2013  |  Volume : 59  |  Issue : 4  |  Page : 343  

Authors' reply

KPP Abhilash, AJJ Jonathan, SD Nathaniel, GM Varghese 
 Department of General Medicine , Christian Medical College, Vellore, India

Correspondence Address:
KPP Abhilash
Department of General Medicine , Christian Medical College, Vellore

How to cite this article:
Abhilash K, Jonathan A, Nathaniel S D, Varghese G M. Authors' reply.J Postgrad Med 2013;59:343-343

How to cite this URL:
Abhilash K, Jonathan A, Nathaniel S D, Varghese G M. Authors' reply. J Postgrad Med [serial online] 2013 [cited 2021 Apr 20 ];59:343-343
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Thank you for the correspondence. [1] I appreciate the author for his comments on our article titled "Eschar in scrub typhus: A valuable clue to the diagnosis" published in J Post grad Med (2013; 59:177-178). I differ in his opinion that an eschar is rarely seen in the south East Asia and Indian subcontinent regions. Scrub typhus is an emerging infectious disease in India with an eschar being the pathognomonic sign of infection. Recent studies by Chrispal et al in the same hospital and Vivekananda et al from a hospital near the same geographic location showed the incidence of an eschar to be 45.6% and 46% respectively. [1],[2] Also the study quoted by the author to say that an eschar is rarely seen in the Indian subcontinent had a study population of only 15 patients where as studies with a larger sample size have shown an eschar to be present in approximately 50% of patients with scrub typhus. [2],[3],[4] Therefore the presence of an eschar is of proven diagnostic value and hence we conducted our study to determine the common locations of an eschar. As an eschar is usually seen in the covered areas of the body it may not be noticed unless a thorough search is performed. Our study would certainly help medical practitioners across India in the search for an eschar in patients with suspected scrub typhus, wherein advanced diagnostic facilities for diagnosing scrub typhus are not available.


1Raina SK. Eschar in scrub typhus: A valuable clue to the diagnosis. J Postgrad Med 2013;59:342-3.
2Chrispal A, Boorugu H, Gopinath KG, Prakash JA, Chandy S, Abraham OC, et al. Scrub typhus: An unrecognized threat in South India - clinical profile and predictors of mortality. Trop Doct 2010;40:129-33.
3Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S, Purty S, et al. Outbreak of Scrub typhus in Pondicherry. JAPI 2010;58:24-8.
4Narvencar KP, Rodrigues S, Nevrekar RP, Dias L, Dias A, Vaz M, et al. Scrub typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res 2012;136:1020-4.

Tuesday, April 20, 2021
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