Abstract
Objective
To compare scrub typhus meningitis with bacterial and tuberculous meningitis.
Methods
Children aged<15 years admitted with meningitis were screened and those who fit criteria for diagnosis of scrub typhus meningitis (n=48), bacterial meningitis (n=44) and tuberculous meningitis (n=31) were included for analysis. Clinical features, investigations and outcomes were compared between the three types of meningitis.
Results
Mean age, duration of fever at presentation, presence of headache and, altered sensorium and presence of hepatomegaly/splenomegaly were statistically significantly different between the groups. Scrub typhus had statistically significant thrombocytopenia, shorter hospital stay and a better neurological and mortality outcome.
Conclusions
Sub-acute presentation of meningitis in older age group children, and good outcome is associated with scrub typhus when compared to bacterial and tuberculous meningitis.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Brouwer MC, McIntyre P, Prasad K, van de Beek D. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2015;9:CD004405.
Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:317–28.
Chiang SS, Khan FA, Milstein MB, Tolman AW, Benedetti A, Starke JR, et al. Treatment outcomes of childhood tuberculous meningitis: a systematic review and metaanalysis. Lancet Infect Dis. 2014;14:947–57.
Viswanathan S, Muthu V, Iqbal N, Remalayam B, George T. Scrub typhus meningitis in south India: A retrospective study. PLoS one. 2013;8:e66595.
Bhat NK, Pandita N, Saini M, Dhar M, Ahmed S, Shirazi N, et al. Scrub typhus: A clinico-laboratory differentiation of children with and without meningitis. J Trop Pediatr. 2016;62:194–9.
Paris DH, Shelite TR, Day NP, Walker DH. Unresolved problems related to scrub typhus: A seriously neglected life-threatening disease. Am J Trop Med Hyg. 2013;89:301–7.
Isaac R, Varghese GM, Mathai E, Manjula J, Joseph I. Scrub typhus: prevalence and diagnostic issues in rural Southern India. Clin Infect Dis. 2004;39:1395–6.
Marais S, Thwaites G, Schoeman JF, Torok ME, Misra UK, Prasad K, et al. Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis. 2010;10:803–812.
Nigrovic LE, Kuppermann N, Malley R, Macias JT, Moro-Sutherland DM, Schremmer RD, et al. Children with bacterial meningitis presenting to the emergency department during the pneumococcal conjugate vaccine era. Acad Emerg Med. 2008;15:522–8.
Nabukeera-Barungi N, Wilmshurst J, Rudzani M, Nuttall J. Presentation and outcome of tuberculous meningitis among children: experiences from a tertiary children’s hospital. Afr Health Sci. 2014;14:143–9.
Varghese GM, Mathew A, Kumar S, Abraham OC, Trowbridge P, Mathai E. Differential diagnosis of scrub typhus meningitis from bacterial meningitis using clinical and laboratory features. Neurol India. 2013;61:17–20.
Well GTJ van, Paes BF, Terwee CB, Springer P, Roord JJ, Donald PR, et al. Twenty years of pediatric tuberculous meningitis: A retrospective cohort study in the western cape of South Africa. Pediatrics. 2009;123:e1–8.
Kundavaram AP, Jonathan AJ, Nathaniel SD, Varghese GM. Eschar in scrub typhus: a valuable clue to the diagnosis. J Postgrad Med. 2013;59:177–8.
Rose W, Rajan RJ, Punnen A, Ghosh U. Distribution of eschar in pediatric scrub. typhus. J Trop Pediatr. 2016;62:415–20.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Kakarlapudi, S.R., Chacko, A., Samuel, P. et al. Comparison of Scrub Typhus Meningitis with Acute Bacterial Meningitis and Tuberculous Meningitis. Indian Pediatr 55, 35–37 (2018). https://doi.org/10.1007/s13312-018-1224-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-018-1224-5