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Clinical profile and predictors of severity in paediatric scrub typhus with pulmonary involvement

Dinesh Kumar Narayanasamy1, Thirunavukkarasu Arun Babu2, Prakash Mathiyalagen3

  • 1Assistant Professor, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal, India.

Tropical Doctor
|May 6, 2021
PubMed

Insights

Scrub typhus frequently causes lung issues in children. Factors like prolonged fever, facial swelling, rash, and anemia predict severe pulmonary involvement in pediatric scrub typhus cases.

Area of Science:

  • Pediatric Infectious Diseases
  • Pulmonology
  • Microbiology

Background:

  • Scrub typhus, a bacterial infection, commonly affects children.
  • Pulmonary complications are a significant concern in pediatric scrub typhus.
  • Understanding predictors of severity is crucial for timely intervention.

Purpose of the Study:

  • To characterize pulmonary involvement in pediatric scrub typhus.
  • To identify clinical and laboratory predictors of severe pulmonary disease.

Main Methods:

  • Retrospective analysis of 506 scrub typhus serology-positive children.
  • Comparison of severe (n=50) versus non-severe pulmonary involvement cases.
  • Logistic regression analysis to determine significant predictors.

Main Results:

  • 50.5% of cases had pulmonary symptoms; 9.8% were severe.
  • Interstitial pneumonitis was the most common radiographic finding.
  • Predictors of severe involvement included fever clearance time >48 hours, facial puffiness, maculopapular rash, and anemia.

Conclusions:

  • Pulmonary involvement is prevalent in pediatric scrub typhus.
  • Specific clinical signs strongly correlate with disease severity.
  • Early identification of these predictors can guide management of severe cases.

Keywords:
Scrub typhuschildreninfantinterstitial pneumonitispulmonary

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