Clinical profile of scrub typhus in children treated in a tertiary care hospital in eastern India

Sarangi, Rachita; Pradhan, Sarita; Debata, Nagen ch; Mahapatra, Sebabrata

doi:10.1016/j.pepo.2016.04.005

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…2 However, in previous studies there was no difference in prevalence of scrub typhus in males and females. 3,6,7 Fever is almost universal in these cases and was seen in all cases in our study. Fever can be of short (<7 days) or long (>7 days) duration.…”

Section: Discussionsupporting

confidence: 61%

“…Clinical presentation present study was similar to previous reports of scrub typhus from all around India. [4][5][6]10 Nausea with or without vomiting was significantly higher in females and younger patients whereas headache found in significantly higher proportion of young patients. Among clinical signs, a higher degree of temperature in males than females and in older patients along higher relative tachycardia in older patients were statistically significant observations.…”

Section: Discussionmentioning

confidence: 99%

“…3 Scrub typhus has been identified and reported from various parts of India. [4][5][6][7] However, there are scant reports from Central India region. Further, scrub typhus has been reported in all ages and both genders.…”

Section: Introductionmentioning

confidence: 99%

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Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

Deshmukh¹,

Saoji²,

Deshmukh³

et al. 2016

Int J Res Med Sci

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

Deshmukh¹,

Saoji²,

Deshmukh³

et al. 2016

Int J Res Med Sci

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“…A prospective study from India has reported respiratory complications like pneumonia and ARDS in 46%, encephalopathy in 12% and AKI in 7.6% in comparison to 38%, 19%, and 6% in the present study. 17 In the present study, the severe cases were treated with injectable chloramphenicol and those who had mild to moderate presentation were treated with either chloramphenicol, azithromycin, doxycycline or in combination form. This was because the treatment was based on a high index of suspicion and the confirmatory results were obtained only retrospectively, after the cases were either discharged or had succumbed.…”

Section: 12mentioning

confidence: 99%

Scrub typhus an emerging public health threat in Eastern Nepal: an analysis from a tertiary centre during two years outbreak

Yadav

Dharel

Shah

et al. 2018

Int J Contemp Pediatr

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Background: Scrub typhus is an emerging disease in the eastern part of Nepal. Varied clinical presentation and lack of laboratory resources make diagnosis difficult. Epidemic outbreaks have been reported from different parts of Nepal. The objective of this study was to describe the clinical presentation, complications, laboratory profile and outcome of admitted cases with scrub typhus.Methods: The cases (1 month to 15 years) admitted in paediatric ward or intensive care with confirmed serological diagnosis of scrub typhus over a period of two years 2015 and 2016, were retrospectively evaluated from the maintained records. All the clinical and laboratory parameters along with intervention and outcome were analysed by descriptive statistics.Results: There were 52 cases of scrub typhus of which 30 were female and 22 males. The youngest case was 2.5 months old and the median age was 3.6 years, mode being 14 years (7 cases). Majority (>71%) of cases were from the hilly districts. Mean duration of illness at presentation was 7.8±2.7 days and ≥94% of the cases had temperature of ≥102°F. More than half of the cases had hepatomegaly (78%), splenomegaly (53.8%), respiratory symptoms (53.8%) and the classical eschar (55.8%). The mean haemoglobin of the cases was below 10 g/dl and the mean platelet count was below 70,000/cu mm, along with hyponatremia, hypoalbuminemia and elevated liver enzymes. X-rays showing variable infiltrates were seen in 59.6%. Respiratory complications like pneumonia and acute respiratory distress syndrome (ARDS) were seen in 46%, encephalopathy in 12%, myocarditis in 40.2%and acute kidney injury in 7.6%. Twenty percent of the cases required intensive care management. There was 15.4% mortality, and all the cases who succumbed had ARDS and myocarditis.Conclusions: In this study the main clinical features were hepatomegaly, splenomegaly, respiratory symptoms and the classical eschar. Mortality was 15.4%. ARDS and myocarditis were present in all cases who died.

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“…Seventy-seven per cent of the study population reported open defecation which is closely linked to the possibility of exposure to trombiculid mite. 5,13,23 Since this study was conducted before the introduction of government measures to reduce open defecation by providing toilets at home, a survey done later may give a different data following the use of indoor toilets.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profile of pediatric scrub typhus in a tertiary care teaching hospital in Southern India

Lakshmanan

Sagayaraj

Sujatha

et al. 2018

Int J Contemp Pediatr

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Background: Scrub typhus is a common aetiology for an acute undifferentiated fever among children. Early recognition and prompt management help to reduce morbidity and mortality.Methods: All children who visited our pediatric out-patient department between January 2016 and February 2018, admitted with clinical suspicion of scrub typhus and having positive serum IgM by ELISA were included in the study.Results: A total of 83 cases were enrolled during the study period. Of these 55 were boys and 28 girls. The average age of presentation was seven years, and the youngest was just five months old. Majority of these patients were from rural areas (86%). Roughly, two-thirds (77%) of the study group practiced open defecation. A maximum number of cases (65;78.3%) were reported during monsoon season (between September and January).Prolonged fever (100%), gastrointestinal symptoms (76%) such as vomiting, diarrhoea and abdominal pain, lymphadenopathy (96%) and hepatosplenomegaly (61%) were common signs and symptoms of pediatric scrub typhus. Only six patients had severe illnesses. The diagnosis was based on the positive serum IgM for scrub typhus. All the patients were IgM positive. Out of these 83 patients, eschar was seen in 50 (60%) patients. Weil Felix test was positive in 15 cases out of 33 tested cases. Six children had co-infection with 2 cases of malaria and four dengue fever cases.Conclusions: Scrub typhus is one of the common causes for acute undifferentiated fever among children. A high index of clinical suspicion and a lookout for an eschar shall facilitate an early diagnosis of scrub typhus.

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Clinical profile of scrub typhus in children treated in a tertiary care hospital in eastern India

Cited by 12 publications

References 17 publications

Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

Scrub typhus an emerging public health threat in Eastern Nepal: an analysis from a tertiary centre during two years outbreak

Clinical and laboratory profile of pediatric scrub typhus in a tertiary care teaching hospital in Southern India

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