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Predictors of Severity in Pediatric Scrub Typhus

Dinesh Kumar Narayanasamy1, Thirunavukkarasu Arun Babu2, Vijayasankar Vijayadevagaran1

  • 1Department of Pediatrics, Indira Gandhi Medical College and Research Institute (IGMC&RI), Pondicherry, India.

Indian Journal of Pediatrics
|January 26, 2018
PubMed

Insights

Five key factors predict severe scrub typhus in children: breathlessness, altered sensorium, leucocytosis, hypoalbuminemia, and hyponatremia. Early identification aids in timely intervention for better outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Clinical Medicine

Background:

  • Scrub typhus is a significant cause of febrile illness in children in endemic areas.
  • Identifying predictors of severe scrub typhus is crucial for risk stratification and management.
  • Current criteria for severe scrub typhus in children are adapted from adult studies.

Purpose of the Study:

  • To determine clinical and laboratory factors that predict the severity of scrub typhus in pediatric patients.
  • To identify specific indicators for early recognition of severe cases in children.

Main Methods:

  • A prospective study conducted in a tertiary care hospital from November 2014 to October 2016.
  • Included children under 12 years old with fever >7 days and positive IgM ELISA for scrub typhus.
  • Utilized multivariate analysis to identify significant predictors of severe scrub typhus based on established criteria.

Main Results:

  • Out of 230 children with scrub typhus, 91 (40.6%) had severe disease.
  • Multivariate analysis identified five significant predictors: breathlessness (OR: 6.85), altered sensorium (OR: 11.48), leucocytosis (OR: 3.38), hypoalbuminemia (OR: 10.78), and hyponatremia (OR: 10.08).
  • These factors were strongly associated with severe scrub typhus in the pediatric cohort.

Conclusions:

  • Breathlessness, altered sensorium, leucocytosis, hypoalbuminemia, and hyponatremia are significant predictors of severe scrub typhus in children.
  • These findings can assist clinicians in identifying high-risk pediatric patients requiring intensive monitoring and prompt treatment.
  • Early recognition of these warning signs is vital for improving patient outcomes in childhood scrub typhus.
Abstract

Keywords:
ChildrenIgM ELISAPredictorsScrub typhusSeverity

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