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Scrub typhus: audit of an outbreak
Mani Ram Krishna1, B Vasuki, K Nagaraju
1Department of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital, 12A, Nageshwara Road, Nungambakkam, Chennai, 600034, India, mann_comp@hotmail.com.
Insights
Scrub typhus in children presents with fever, leg swelling, and vomiting. Key indicators include eschar, enlarged liver and spleen, and elevated C-reactive protein (CRP), aiding diagnosis and treatment response.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology of Tropical Diseases
- Clinical Microbiology
Background:
- Scrub typhus is a significant cause of febrile illness in children in endemic regions.
- Early diagnosis and treatment are crucial to prevent severe complications.
Purpose of the Study:
- To delineate the epidemiological, clinical, and laboratory features of pediatric scrub typhus.
- To identify key diagnostic markers and assess treatment outcomes in children.
Main Methods:
- Retrospective analysis of case records of children diagnosed with scrub typhus.
- Data collection included presenting symptoms, physical findings, laboratory parameters, and complications.
Main Results:
- Fever was universal; leg swelling and vomiting were common. Eschar (67%), hepatomegaly (94%), and splenomegaly (73%) were frequent findings.
- Laboratory results showed elevated C-reactive protein (CRP) (92%), hypoalbuminemia (79%), and leukocytosis (56%).
- Acute kidney injury (10%) and peripheral gangrene (4%) were noted complications, with no mortality.
Conclusions:
- The study highlights the characteristic clinical and laboratory profile of scrub typhus in children.
- Presence of eschar, hepatosplenomegaly, and elevated CRP are valuable diagnostic clues.
- Children showed good response to treatment, emphasizing the importance of timely intervention.
Objectives:
To document the epidemiological, clinical and laboratory profile of all children with scrub typhus at a tertiary care centre in Chennai between September 2010 and June 2011.
Methods:
The case records of all children admitted and diagnosed with scrub typhus between September 2010 and June 2011 were analysed to look for salient clinical and laboratory parameters.
Results:
During the study period, 52 children were admitted with scrub typhus in the authors' hospital. The presenting complaints included fever in all cases. Other symptoms included swelling of legs (50 %) and vomiting (45 %). 13 % presented with CNS symptoms. The commonest physical findings included eschar (67 %), hepatomegaly (94 %), splenomegaly (73 %) and third spacing (67 %). Salient lab parameters included packed cell volume (PCV) <30 (48 %), leucocytosis (56 %), positive C-reactive protein (CRP) (92 %), hypoalbuminemia (79 %). Common complications included acute kidney injury (10 %) and peripheral gangrene (4 %). There was no mortality in the present case series.
Conclusions:
The clinical profile of children with scrub typhus in a tertiary care centre is reported. Eschar and hepatosplenomegaly with a high CRP value is helpful in diagnosis. All patients responded well to the treatment.
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