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Pediatric scrub typhus in Indian Himalayas
Sanjay K Mahajan1, Jean-Marc Rolain, Naveen Sankhyan
1Department of Pediatrics, IG Medical College, Shimla, HP, India. sanjay_mahajan64@rediffmail.com
Indian Journal of Pediatrics
|November 18, 2008
Summary
This study confirms scrub typhus in Indian children with fever using microimmunofluorescence. Azithromycin proved effective, with one patient treated successfully, highlighting its role in managing this rickettsial disease.
Area of Science:
- Pediatric infectious diseases
- Rickettsial disease diagnostics
- Tropical medicine
Background:
- Scrub typhus, a rickettsial infection, presents diagnostic challenges in pediatric febrile illnesses.
- Accurate diagnosis is crucial for timely and effective treatment, especially in endemic regions like the Indian Himalayas.
Observation:
- Five pediatric patients with acute febrile illness of unknown origin were evaluated.
- Clinical presentations included fever, vomiting, and lymphadenopathy; eschar and rash were notably absent in all cases.
- Microimmunofluorescence served as the gold standard for confirming suspected scrub typhus.
Findings:
- Microimmunofluorescence confirmed scrub typhus in all five pediatric patients.
- Doxycycline and azithromycin were used for treatment, with azithromycin showing effectiveness in four cases.
- One patient unfortunately died despite treatment, underscoring the severity of potential complications.
Implications:
- Scrub typhus is a significant cause of fever of unknown origin in the Himalayan region of India.
- Azithromycin is a viable and effective alternative treatment for scrub typhus when doxycycline is not suitable.
- Enhanced diagnostic approaches and prompt treatment are vital for improving outcomes in pediatric scrub typhus cases.
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