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Clinical Predictors of Multiple Organ Dysfunction Syndromes in Pediatric patients with Scrub Typhus

Dongying Zhao1, Yongjun Zhang1,2, Zhaoqing Yin3

  • 1Xin Hua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.

Journal of Tropical Pediatrics
|October 5, 2016
PubMed

Insights

Identifying children at risk of Multiple Organ Dysfunction Syndrome (MODS) from scrub typhus is crucial. Key indicators include skin rash, elevated liver enzymes, and altered blood counts, aiding early intervention and improved outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Scrub typhus, a bacterial infection, can lead to Multiple Organ Dysfunction Syndrome (MODS) in children.
  • Early identification of pediatric patients at risk for MODS is essential for timely management and reduced mortality.

Purpose of the Study:

  • To identify prognostic factors associated with the development of MODS in pediatric scrub typhus patients.
  • To provide clinicians with data for improved clinical monitoring and prognostication of MODS in this population.

Main Methods:

  • A retrospective study involving 449 pediatric scrub typhus patients from three hospitals in Yunnan, China (January 2010 - January 2015).
  • Patients were evaluated for organ system dysfunction using standard criteria upon hospital discharge.
  • Multivariate logistic regression analysis was employed to determine risk factors for MODS.

Main Results:

  • 14.3% of pediatric scrub typhus patients developed MODS.
  • Significant prognostic factors for MODS included skin rash (OR=3.3), prolonged time to defervescence (OR=1.2), low hemoglobin (OR=0.54), low platelet counts (OR=0.06), elevated AST (OR=4.7), and elevated total bilirubin (OR=2.3).

Conclusions:

  • Skin rash, delayed fever resolution, altered hemoglobin and platelet counts, and elevated liver/bilirubin levels are significant indicators for MODS in pediatric scrub typhus.
  • These findings can enhance clinical monitoring and risk assessment for MODS in children with scrub typhus.

Keywords:
children.clinical predictorseschar scrub typhusmultiple organ dysfunction syndromes

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