European Journal of Pediatrics

, Volume 177, Issue 6, pp 887–890 | Cite as

Clinical profile and outcome of children with scrub typhus from Chennai, South India

  • Ramaswamy Ganesh
  • Natarajan Suresh
  • L. L. Pratyusha
  • Lalitha Janakiraman
  • Mani Manickam
  • A. Andal
Original Article


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%.

Conclusion: Our 4-year study highlights the clinico-laboratory profile of Scrub typhus in children from Chennai, South India. Early recognition and prompt treatment reduces the complication and mortality.

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.


Scrub typhus Children AST Thrombocytopenia Neonates 



Aspartate aminotransferase


Acute respiratory distress syndrome


Multi organ dysfunction syndrome


Pediatric intensive care unit


Polymerase chain reaction


Cerebro spinal fluid


White blood cells


Authors’ contributions

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

Informed consent was obtained from parents of all children who were included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ramaswamy Ganesh
    • 1
  • Natarajan Suresh
    • 1
  • L. L. Pratyusha
    • 1
  • Lalitha Janakiraman
    • 1
  • Mani Manickam
    • 1
  • A. Andal
    • 1
  1. 1.Kanchi Kamakoti CHILDS Trust Hospital & The CHILDS Trust Medical Research FoundationChennaiIndia

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