Clinical profile and outcome of children with scrub typhus from Chennai, South India
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. We prospectively studied the clinico-laboratory profile and outcome of 358 children aged 1 day to 18 years diagnosed with scrub typhus from Chennai, South India. All children (100%) had fever. Eschar was seen in 67%. All children were treated with oral doxycycline and those with complications were treated with intravenous chloramphenicol/azithromycin. Rapid defervescence (within 48 h) after initiation of doxycline was seen in 306 (85%) and 52 (14.5%) developed complications. Multivariate logistic regression analysis revealed that children who had an elevated aspartate amino transferase (> 120 IU/L) and the presence of thrombocytopenia (platelet count less than 1 lac cells/mm3) at admission had high risk of developing complications. The overall mortality rate in this series was 0.8%.
What is Known:
• Scrub typhus is endemic to tsutsugamushi triangle, a geographical triangle extending from northern Japan in the east to Pakistan and Afghanistan in the west and northern Australia in the south.
• There is paucity of data regarding its clinico-laboratory profile in neonates as well as its predictors of outcome.
What is New:
• Children who had an elevated AST and the presence of thrombocytopenia at admission had high risk of developing complications.
KeywordsScrub typhus Children AST Thrombocytopenia Neonates
Acute respiratory distress syndrome
Multi organ dysfunction syndrome
Pediatric intensive care unit
Polymerase chain reaction
Cerebro spinal fluid
White blood cells
RG: involved in patient management, drafted the manuscript, reviewed the manuscript for intellectual content and will act as guarantor.
NS: involved in patient management and drafted the manuscript.
LLP: collected data, reviewed literature and drafted the mansucript.
LJ: Reviewed literature, involved in patient management and reviewed the manuscript for intellectualcontent.
MM: collected data, reviewed literature and drafted the mansucript.
AA: Reviewed literature, involved in patient management and drafted the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants and/or animals
This article does not contain any studies using animals performed by any of the authors. Since all children were subjected to the well proven treatment guidelines and were not required to behave in a certain manner, this research did not require a full review by the Institutional Ethics Committee of Kanchi Kamakoti CHILDS Trust hospital.
Informed consent was obtained from parents of all children who were included in the study.
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