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Scrub typhus masquerading as other conditions among the pediatric population in India: a case series

Deblina Patra1, Ritajyoti Ghosh1, Sumanta Laha1

  • 1Department of Pediatric Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal 713104, India.

Journal of Tropical Pediatrics
|March 21, 2025
PubMed

Insights

Pediatric scrub typhus in India presents atypically, mimicking other serious conditions. Early diagnosis and treatment with doxycycline are crucial for recovery in children with Orientia tsutsugamushi infection.

Area of Science:

  • Pediatric Infectious Diseases
  • Rickettsial Infections
  • Epidemiology of Scrub Typhus

Background:

  • Scrub typhus, caused by Orientia tsutsugamushi, is endemic in India and commonly affects children.
  • Atypical presentations of pediatric scrub typhus can delay diagnosis, posing a clinical challenge.

Purpose of the Study:

  • To highlight the diverse and sometimes unusual clinical manifestations of scrub typhus in pediatric patients.
  • To emphasize the importance of considering scrub typhus in the differential diagnosis of febrile illnesses in children with varied symptoms.

Main Methods:

  • Case series reporting five febrile children with varied presentations.
  • Diagnostic confirmation through positive scrub typhus IgM antibody tests.
  • Treatment with doxycycline and supportive therapies.

Main Results:

  • Five pediatric cases presented with diverse symptoms including convulsions, jaundice, edema, and features resembling Kawasaki disease.
  • Only one patient exhibited the pathognomonic eschar.
  • All patients were diagnosed with conditions like acute disseminated encephalomyelitis, nephrotic syndrome, hepatitis, or Kawasaki phenotype hyperinflammatory syndrome alongside scrub typhus.
  • All patients recovered with appropriate treatment.

Conclusions:

  • Pediatric scrub typhus can present with a wide spectrum of rare and atypical symptoms.
  • A high index of suspicion is necessary for pediatricians to diagnose scrub typhus promptly in children with presentations similar to those described.
Keywords:
ADEMKawasaki diseasechildrenscrub typhus

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