Acute inflammatory ankle arthritis in Northern India.

Kim sJ et al, in a study, noted 58 patients of total 256 patients of scrub typhus had gastro-intestinal symptoms and were subjected to esophago-gastro-duodenoscopy. The endoscopic findings were graded as Grade I, normal, nonspecific hyperemia; Grade II, distinct hyperemia, petechiae, purpura; Grade III, superficial hemorrhage, erosion; and Grade IV, ulcer, active bleeding. In 83.3% of patients there were multiple lesions without any predilection sites. The patient with clinically severe disease had more endoscopic findings and higher grades of lesions were noted in patients with cutaneous lesions. both patients of scrub typhus in our report with gastro-intestinal bleeding had rash also. The major endoscopic features that can develop in scrub typhus are superficial mucosal hemorrhage, multiple erosions and ulcers without any predilection sites, and unusual vascular bleeding.4 The stomach lesions were more frequent and severe than the duodenal lesions.3