Introduction: Scrub typhus is an acute febrile illness caused by infection with rickettsial bacilli Orientia tsutsugamushi. This was a retrospective observational study to study the clinical profile of paediatric scrub typhus, its associated complications and response to treatmentMaterial and Methods: Record files of all patients diagnosed with positive Weil felix (OXK>1:80) and Scrub IgM positive over a period of one year were analysed. Total of 10 cases were diagnosed as scrub with median age of presentation 4.1 years.Results: Fever was present in all followed by pain abdomen (50%), rash. Anaemia (90%), lymphadenopathy (70%) hepatomegaly (100%), Leukopenia was present in those cases with fever <1 week while leucocytosis was found thereafter. Most common complication were hepatitis (100%) shock (50%), acute kidney injury (AKI) 30%, DIC in 20% cases. Secondary HLH was found in 20% and pancarditis in one case. All the cases showed dramatic response to doxycycline.Conclusion: So a high index of suspicion is required to diagnose scrub and early initiation of treatment is essential to prevent mortality from the disease.
Kawasaki Disease is the most common cause of acquired heart disease in the developed countries. The diagnosis of typical Kawasaki Disease (KD)is not much of a problem. However incomplete Kawasaki Disease where only two to three clinical features are present, poses a diagnostic dilemma. Here we report our experience with the disease in the paediatric department of Vivekananda Institute of Medical Sciences (VIMS). In one year retrospective study from Jan 2015 to Jan 2016, 20 cases were diagnosed as KD, of which five were complete and 15 incomplete. Fifty percent of cases were less than one year’s age and there was male preponderance. More than 90% showed echo changes and all except one responded to IVIG and aspirin who succumbed due to aneurysm rupture. So we conclude that high index of suspicion for diagnosing KD must be there and early treatment to prevent echocardiographic changes.J Nepal Paediatr Soc 2016;36(2):208-212
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