Etiological spectrum and diagnostic challenges of short-duration fever in West Bengal (India). A cross-sectional tertiary care study

• Published in: Revista clínica espanõla (English edition) 2024-08, Vol.224 (7), p.466-473
• Main Authors: Biswas, U., Bhattacharjee, A., Seth, S., Ghosh, R., Singh, A.K., Sohrab, A., Benito-León, J.
• Format: Article
• Language: English
• Subjects: Bengala Occidental rural; Enfermedades Infecciosas; Entorno de atención terciaria; Etiological patterns; Fiebre de corta duración; India; Infectious diseases; Patrones etiológicos; Rural West Bengal; Short-duration fever; Tertiary care setting
• ISSN: 2254-8874; 2254-8874
• DOI: 10.1016/j.rceng.2024.06.009

The scarcity of epidemiological data on acute febrile illnesses from South Asia impairs evidence-based clinical decision-making. Our study aimed to explore the etiological spectrum of short-duration fever in patients admitted to a tertiary care hospital in West Bengal, India. We conducted a cross-sectional study from May 2021 to April 2022 involving 150 adult patients presenting with a fever lasting less than two weeks at Burdwan Medical College and Hospital (West Bengal, India). We performed comprehensive clinical assessments, including microbiological, serological, and other specific investigations, to identify the causes of the fever. The demographic profile predominantly included individuals aged 21–40 years, with a male-to-female ratio of 1.9:1; 60.7% of participants were from rural areas. The primary etiological agents identified were scrub typhus (25.3%), dengue (15.3%), and enteric fever (13.3%). Notably, 80% of patients presented with non-localizing symptoms, while 14.7% had respiratory symptoms. Blood cultures pinpointed Salmonella typhi and Staphylococcus aureus in a minority of cases (3.3%); malaria, primarily Plasmodium vivax, was diagnosed in 12% of the cases. Our findings highlight the complexity of diagnosing short-duration fevers, dominated by a wide range of etiological agents, with a notable prevalence of scrub typhus. These results underscore the urgent need for enhanced diagnostic facilities, including the availability of scrub typhus testing at primary healthcare centers. We recommend empirical doxycycline therapy for suspected cases and emphasize the need for further research to develop management guidelines for acute febrile illnesses. This study also highlights the importance of raising both community and clinician awareness to prevent irrational antibiotic use. La escasez de datos epidemiológicos sobre enfermedades febriles agudas en el sur de Asia dificulta la toma de decisiones clínicas basadas en la evidencia. Nuestro estudio tuvo como objetivo explorar el espectro etiológico de la fiebre de corta duración en pacientes ingresados en un hospital de atención terciaria en Bengala Occidental, India. Realizamos un estudio transversal desde mayo de 2021 hasta abril de 2022 que involucró a 150 pacientes adultos que presentaban fiebre de menos de dos semanas de duración ingresados en el Burdwan Medical College and Hospital (Bengala Occidental, India). Realizamos evaluaciones clínicas exhaustivas, incluidas investigaciones microbiológic