Neonatal Scrub Typhus—A Case Report

Mehta, Abha; Choudhary, Sangeeta; Bagri, Dhan Raj; Choudhary, Ramesh; Vajpayee, Shailja

doi:10.1177/09732179221100609

Cited by 2 publications

(4 citation statements)

References 10 publications

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“…Among others, the baby described in our case also had thrombocytopaenia, fever, hepatosplenomegaly and shock. Vertical transmission confirmed by positive serology for scrub typhus was reported in four cases 5–7 15. Among the cases where vertical transmission was suspected, PCR was either not done or negative in three of the cases,5 6 15 and positive in one7 but none of the previously reported studies reported on maternal PCR.…”

Section: Discussionmentioning

confidence: 84%

“…Vertical transmission confirmed by positive serology for scrub typhus was reported in four cases 5–7 15. Among the cases where vertical transmission was suspected, PCR was either not done or negative in three of the cases,5 6 15 and positive in one7 but none of the previously reported studies reported on maternal PCR. PCR was positive in both the neonate and the mother in our case, making the evidence for vertical transmission more robust.…”

Section: Discussionmentioning

confidence: 84%

“…While scrub typhus during pregnancy treated adequately is associated with favourable maternal and fetal outcomes, adverse fetal outcomes such as spontaneous abortion, preterm labour, small for gestational age and stillbirth have also been reported 4. Scrub typhus in neonates is rare, with only 22 cases reported so far 5–15. All affected neonates manifested with fever and hepatosplenomegaly (100%), whereas thrombocytopaenia (21/22), shock (12/21), Disseminated intravascular coagulation or DIC (8/21), Multi-organ dysfunction syndrome or MODS (6/21), respiratory failure (9/22) and eschar (4/22) were the other clinical manifestations.…”

Section: Discussionmentioning

confidence: 99%

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Scrub typhus due to vertical transmission in a neonate: rare presentation of a common tropical infection

et al. 2023

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Vertical transmission as a route of infection has been well reported in many viral infections. Scrub typhus is a zoonotic disease transmitted by ticks which has had a resurgence in recent times in several tropical countries. It affects all age groups including neonates. Reports of neonates affected with scrub typhus are few, and vertical transmission is rare. We report a case, where a newborn was symptomatic with signs of infection within the first 72 hours of life and Orientia tsutsugamushi, the causative organism was confirmed by PCR in both mother and baby.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Scrub typhus due to vertical transmission in a neonate: rare presentation of a common tropical infection

et al. 2023

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“…Treatment should continue until the patient becomes afebrile for 3 days or 7–10 days. However, some experts disagree with doxycycline as the first choice of treatment, particularly in neonates, because of its potential side effects, and instead prefer azithromycin and clarithromycin ( 24 ). Macrolides, including azithromycin, are considered safe for use during pregnancy and in young children, with a recommended dose of 10 mg/kg/day (maximum 500 mg) for 5 days ( 2 , 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

Congenital scrub typhus: a case report and literature review

Liang,

Su,

Chen

et al. 2023

Front. Pediatr.

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BackgroundThis study aimed to analyze the clinical course of a newborn with congenital scrub typhus caused by vertical transmission and explore early diagnosis and treatment strategies. The clinical data of the neonate were retrospectively analyzed and the related literature was reviewed.Case presentationThe newborn was a full-term one, with a good Apgar score at birth. The neonate had apnea at 3 h of life, requiring NICU care and IV antibiotics (piperacillin) for suspected sepsis. An examination revealed hepatosplenomegaly. Blood tests revealed anemia and thrombocytopenia and a chest x-ray showed patchy inflammation. On the second day of life, he developed a fever. On the third day of life, he required mechanical ventilation because his condition worsened after he presented with dyspnea, hypotension, depressed sensorium, and other signs of sepsis. Importantly, the neonate's mother had a history of scrub typhus at 31+ weeks of gestation. While the blood culture result was still pending, high-throughput sequencing of blood and cerebrospinal fluid was performed. To address the suspected scrub typhus infection, oral azithromycin dry suspension was added to the treatment regimen. High-throughput sequencing results on the 5th day of life confirmed a significant presence of 16SrRNA sequences in the blood, suggesting an Orientia tsutsugamushi infection. The neonate steadily recovered and was discharged 16 days after hospitalization. The neonate was followed up for 9 months, and the outcome was favorable with normal growth and development.ConclusionsThis article reports a case of congenital Orientia tsutsugamushi infection, a rare condition caused by vertical transmission. Our review of the literature, combined with the presented case, brings the total number of documented congenital scrub typhus cases caused by vertical transmission to eight. Regrettably, one patient from this group unexpectedly died on the 10th day of hospitalization, resulting in a mortality rate of 12.5% (1/8). The special transmission mode and clinical manifestations of this disease will serve as an alert to doctors for timely diagnosis and treatment. Because of the non-specific clinical manifestations of congenital scrub typhus, limited understanding, low index of suspicion among clinicians, and a lack of diagnostic facilities, scrub typhus is seriously underdiagnosed in pregnant women, fetuses, and neonates.

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Neonatal Scrub Typhus—A Case Report

Cited by 2 publications

References 10 publications

Scrub typhus due to vertical transmission in a neonate: rare presentation of a common tropical infection

Scrub typhus due to vertical transmission in a neonate: rare presentation of a common tropical infection

Congenital scrub typhus: a case report and literature review

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