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Clinical Manifestations and Outcome of Scrub Typhus in Infants From Odisha
Jyoti Ranjan Behera1, Sanjay Kumar Sahu1, Niranjan Mohanty1
1Department of Pediatrics, Kalinga Institute of Medical Sciences, KIIT Deemed University, Bhubaneswar, India.
Insights
Scrub typhus in infants often presents severely with fever, feeding difficulties, and anemia. Early doxycycline treatment leads to good recovery, even in intensive care cases.
Area of Science:
- Pediatric infectious diseases
- Rickettsial infections
- Public health
Background:
- Scrub typhus, a rickettsial disease, poses a significant threat globally.
- Infant infections often present with unique challenges and potential severity.
- Understanding specific pediatric manifestations is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the clinical manifestations and outcomes of scrub typhus specifically in infants.
- To identify key signs, symptoms, and laboratory findings in this age group.
- To evaluate the effectiveness of treatment in affected infants.
Main Methods:
- Retrospective case record analysis of infants diagnosed with scrub typhus.
- Inclusion criteria: IgM ELISA confirmed cases admitted to a tertiary care hospital.
- Data collected from January 2016 to December 2019.
Main Results:
- Out of 374 scrub typhus cases, 34 (9%) were infants.
- Common symptoms included fever (100%), feeding difficulty (70.6%), lethargy (52.9%), and irritability (44.1%).
- Key clinical findings were pallor (88.2%), tachycardia (85.3%), tachypnea (70.6%), hepatosplenomegaly (88.2%), and eschar (17.6%).
- Laboratory findings revealed anemia (97.1%), leukocytosis (97.1%), thrombocytopenia (50%), and transaminitis (63.6%).
- Pneumonia (52.9%) was the most frequent complication.
- Infants needing intensive care (50%) showed thrombocytopenia, hypoalbuminemia, and transaminitis (P<0.05).
Conclusions:
- Scrub typhus in infants frequently manifests severely, involving hematologic, pulmonary, and hepatic systems.
- Intensive care may be required for complicated cases.
- Doxycycline demonstrates effective treatment outcomes in infant scrub typhus.
Objective:
To study manifestations and outcome of scrub typhus in infants.
Methods:
Case record analysis of infants with scrub typhus admitted to a tertiary care hospital, diagnosed by IgM ELISA from January 1, 2016 to December 31, 2019.
Results:
Out of 374 children diagnosed with scrub typhus, 34 (9%) were infants. Chief presentation were fever 34 (100 %), feeding difficulty 24 (70.6%), lethargy 18 (52.9%) and irritability 15 (44.1%). Clinically, pallor 30 (88.2%), tachycardia 29 (85.3%), tachypnea 24 (70.6%), hepatosplenomegaly 30 (88.2%) and eschar 6 (17.6%) were detected. Significant laboratory parameters were anemia 33 (97.1%), leukocytosis 33 (97.1%), thrombocytopenia 17 (50%) and transaminitis 21 (63.6%). Pneumonia 18 (52.9%) was noticed as the major complication. Infants requiring intensive care 17(50%) had characteristic thrombocytopenia, hypoalbuminemia and transaminitis (P<0.05). They recovered well with doxycycline.
Conclusions:
Manifestation of scrub typhus in infants tends to be severe with combination of hematologic, pulmonary and hepatic involvement requiring intensive care. The response to doxycycline is good.
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