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IAP guidelines on rickettsial diseases in children

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Abstract

Objective

To formulate practice guidelines on rickettsial diseases in children for pediatricians across India.

Justification

Rickettsial diseases are increasingly being reported from various parts of India. Due to low index of suspicion, nonspecific clinical features in early course of disease, and absence of easily available, sensitive and specific diagnostic tests, these infections are difficult to diagnose. With timely diagnosis, therapy is easy, affordable and often successful. On the other hand, in endemic areas, where healthcare workers have high index of suspicion for these infections, there is rampant and irrational use of doxycycline as a therapeutic trial in patients of undifferentiated fevers. Thus, there is a need to formulate practice guidelines regarding rickettsial diseases in children in Indian context.

Process

A committee was formed for preparing guidelines on rickettsial diseases in children in June 2016. A meeting of consultative committee was held in IAP office, Mumbai and scientific content was discussed. Methodology and results were scrutinized by all members and consensus was reached. Textbook references and published guidelines were also used in few instances to make recommendations. Various Indian and international publications pertinent to present study were collated and guidelines were approved by all committee members. Future updates in these guidelines will be dictated by new scientific data in the field of rickettsial diseases in children.

Recommendations

Indian tick typhus and scrub typhus are commonly seen rickettsial diseases in India. It is recommended that practicing pediatricians should be well conversant with compatible clinical scenario, suggestive epidemiological features, differential diagnoses and suggestive laboratory features to make diagnosis and avoid over diagnosis of these infections, as suggested in these guidelines. Doxycycline is the drug of choice and treatment should begin promptly without waiting for confirmatory laboratory results.

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Author information

Authors and Affiliations

  1. Smile Healthcare, Rehabilitation & Research Foundation, Smile Institute of Child Health, Ramdaspeth, Akola, Maharashtra, India

    Narendra Rathi

  2. Department of Pediatrics, Ashwini Medical College, Solapur, India

    Atul Kulkarni

  3. Dr Yewale Multispeciality Hospital for Children, Navi Mumbai, India

    Vijay Yewale

Authors
  1. Narendra Rathi
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  2. Atul Kulkarni
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  3. Vijay Yewale
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Consortia

Indian Academy of Pediatrics Guidelines on Rickettsial Diseases in Children Committee

Corresponding author

Correspondence to Narendra Rathi.

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Rathi, N., Kulkarni, A., Yewale, V. et al. IAP guidelines on rickettsial diseases in children. Indian Pediatr 54, 223–229 (2017). https://doi.org/10.1007/s13312-017-1035-0

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  • DOI: https://doi.org/10.1007/s13312-017-1035-0

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