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

Deglurkar, Revati; Thangavel, N.; Murugesan, Ambalakkuthan; Plakkal, Nishad

doi:10.1136/bcr-2022-253172

Cited by 2 publications

(3 citation statements)

References 12 publications

(20 reference statements)

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“…The modes of transmission in neonates may include mite-borne transmission, trans-placental transmission, and perinatal blood-borne transmission ( 16 ). A brief literature review reveals 22 reported cases of neonatal scrub typhus ( 8 ). Most cases were attributed to mite-borne transmission, while a few were associated with trans-placental transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Among these diagnostic methods, molecular-based methods such as PCR and NGS exhibit higher specificity and sensitivity ( 19 ). However, during the acute stage of neonatal scrub typhus, the results of the serological test often turn out to be negative, which can lead to misdiagnosis and a high risk of complications and mortality ( 8 ). Therefore, it is crucial to consider scrub typhus as a potential diagnosis in children and initiate prompt treatment ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few clinical reports and studies on congenital scrub typhus in China and worldwide. Only eight cases of congenital scrub typhus have been reported (4)(5)(6)(7)(8)(9)(10), leaving aspects of its clinical presentation and treatment relatively unexplored. In this study, we discuss the clinical course of a newborn with congenital scrub typhus and review relevant literature to gain insights into the clinical characteristics and treatment of this condition.…”

mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%