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Profile of Scrub Typhus Meningitis/Meningoencephalitis in Children with and without Scrub Typhus IgM Antibody in CSF

Bijayini Behera1, Amit Kumar Satapathy2, Jai Ranjan1

  • 1Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Journal of Neurosciences in Rural Practice
|November 5, 2021
PubMed

Insights

Scrub typhus meningitis/meningoencephalitis (STM) affects 10.5% of children with scrub typhus in Eastern India. Headache and vomiting predict STM, while hyponatremia and thrombocytopenia suggest non-STM cases.

Area of Science:

  • Pediatric Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Scrub typhus is an infectious disease caused by Orientia tsutsugamushi.
  • Neurological involvement, including meningitis and meningoencephalitis, can occur in scrub typhus.
  • Understanding the clinical spectrum of scrub typhus meningitis/meningoencephalitis (STM) in children is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of scrub typhus meningitis/meningoencephalitis (STM) in pediatric patients.
  • To identify factors associated with neurological involvement in children with scrub typhus.

Main Methods:

  • A study was conducted on children aged ≤14 years presenting with acute undifferentiated febrile illness.
  • Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) was performed on blood and cerebrospinal fluid (CSF) for suspected STM cases.
  • Demographic, clinical, and laboratory data were collected and analyzed using descriptive statistics and univariate analysis.

Main Results:

  • Out of 76 children with scrub typhus (ST), 8 (10.5%) were diagnosed with STM.
  • Five of the STM cases (62.5%) showed detectable ST IgM antibodies in CSF.
  • Headache and vomiting were common symptoms in STM patients, whereas hyponatremia and thrombocytopenia were more frequent in non-STM cases.

Conclusions:

  • Scrub typhus meningitis/meningoencephalitis (STM) occurs in 10.5% of pediatric scrub typhus cases in Eastern India.
  • Headache and vomiting are significant predictors of STM, while hyponatremia and thrombocytopenia are predictors of non-STM.
  • All affected children recovered, with one experiencing sequelae, highlighting the importance of early recognition and treatment.

Keywords:
Orientia tsutsugamushichildrenmeningitismeningoencephalitisscrub typhus

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