Scrub Typhus: Case Definition and Doxycycline or Azithromycin Dose (ICMR, India)
Classifies scrub typhus as suspected, probable or confirmed by ICMR 2015 and gives doxycycline or azithromycin by weight.
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Example
- Days of fever
- 6
- Eschar
- Yes
- Malaria, dengue and typhoid ruled out
- Yes
- Weight in kg
- 60
- Pregnant
- No
- Complicated
- No
Result: Suspected scrub typhus (fever of 6 days); treat now, without waiting for the laboratory. Doxycycline 100 mg twice daily for 7 days (with plenty of fluid, sitting or standing), or azithromycin 500 mg once daily for 5 days.
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What you enter
- Days of fever
- Eschar
- Malaria, dengue and typhoid ruled out
- Weil-Felix 1:80 or more (OX2, OX19, OXK)
- IgM ELISA OD above 0.5
- PCR, or rising paired titers (IFA or IPA)
- Weight in kg
- Pregnant
- Complicated (ARDS, kidney failure, meningoencephalitis, multi-organ dysfunction)
How this is calculated
Citation
DHR-ICMR. Guidelines for diagnosis and management of rickettsial diseases in India. New Delhi: ICMR; 2015. Sections 3.1 (case definitions) and 3.3 (treatment), pp. 15-17. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.