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Prevalence, Clinico-Laboratory Features and Outcomes of Paediatric Scrub Typhus Cases in a Tertiary Care Centre in

Raghunath Murmu1, Gobinda Mondal2, Koushik Biswas3

  • 1Department of Paediatric Medicine, Midnapore Medical College and Hospital, Midnapore, India.

Sultan Qaboos University Medical Journal
|September 5, 2024
PubMed
Abstract

Insights

Scrub typhus affects 4.5% of febrile children in Eastern India, with frequent gastrointestinal symptoms and complications like thrombocytopenia. Early laboratory diagnosis and treatment are crucial for better outcomes.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Epidemiology

Background:

  • Scrub typhus, caused by Orientia tsutsugamushi, is a prevalent rickettsial disease in India.
  • Recent resurgence in Eastern India necessitates understanding its pediatric burden.
  • Chigger mites are the primary vectors for transmission.

Purpose of the Study:

  • To determine the prevalence of scrub typhus in children aged 1-12 years in Eastern India.
  • To describe the clinical and laboratory characteristics of pediatric scrub typhus cases.
  • To identify common complications and treatment outcomes.

Main Methods:

  • Prospective observational study conducted in Kolkata, India (January-December 2019).
  • ELISA-based serology for scrub typhus diagnosis in children with acute febrile illness.
  • Analysis of demographic, clinical, laboratory, and treatment data.

Main Results:

  • Scrub typhus diagnosed in 4.5% (67/1473) of pediatric patients with febrile illness.
  • Common symptoms included fever (7-14 days), vomiting, and abdominal pain.
  • Hepatomegaly and splenomegaly were frequent clinical signs; thrombocytopenia and meningoencephalitis were common complications.
  • Case fatality rate was 1.5%.

Conclusions:

  • Absence of classical eschar in most cases highlights the need for laboratory testing in endemic areas.
  • Prompt treatment with doxycycline or azithromycin can prevent severe complications and reduce mortality.
  • This study underscores the importance of early diagnosis and management of scrub typhus in pediatric populations in Eastern India.
Keywords:
DoxycyclineEnzyme-Linked Immunosorbent AssayFeverIndiaPediatricsRickettsiaceae InfectionsScrub Typhus

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