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Childhood scrub typhus in eastern Taiwan: ten-year experience from a medical center.
Acta Paediatr Taiwan 2007 Nov-Dec; 48(6):332-6AP

Abstract

BACKGROUND

Scrub typhus, a potentially fatal rickettsial infection, is endemic in western Pacific Rims including Taiwan. Most reports have been concerned about mainly adult patients, whereas serologic surveys suggested that as many as one-half of cases of scrub typhus might be in children.

METHODS

We conducted a retrospective study of childhood scrub typhus in our hospital from January 1997 to December 2006. Scrub typhus was diagnosed on the basis of serology tests or polymerase chain reaction (PCR) examination in fifteen children.

RESULTS

Fever and chigger bite history were presented in all 15 cases, and eschar lesion was identified in 12 patients (80%). Nine (60%) patients had headache and six (40%) complained of abdominal pain. Three patients (20%) had meningoencephalitis, and two (13%) hemophagocytic syndrome were confirmed by bone marrow biopsy. One patient died of progressive acute respiratory distress syndrome (ARDS) and pulmonary hemorrhage. Myocarditis was revealed in autopsy. All surviving patient responded well to antibiotic therapy, and the average duration to defervescence after treatment was 1.8 days.

CONCLUSIONS

We conclude that scrub typhus should be taken into consideration among patients of acute systemic febrile illness, especially those with suspected exposure history and typical skin lesion. Although most patients responded well to treatment, severe complications such as meningoencephalitis, interstitial pneumonia, acute respiratory distress syndrome, hemophagocytic syndrome, and myocarditis might lead to morbidity and mortality.

Authors+Show Affiliations

Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18437968

Citation

Yang, Shang-Hsien, et al. "Childhood Scrub Typhus in Eastern Taiwan: Ten-year Experience From a Medical Center." Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi, vol. 48, no. 6, 2007, pp. 332-6.
Yang SH, Ho YH, Chu CH, et al. Childhood scrub typhus in eastern Taiwan: ten-year experience from a medical center. Acta Paediatr Taiwan. 2007;48(6):332-6.
Yang, S. H., Ho, Y. H., Chu, C. H., & Chu, S. Y. (2007). Childhood scrub typhus in eastern Taiwan: ten-year experience from a medical center. Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi, 48(6), pp. 332-6.
Yang SH, et al. Childhood Scrub Typhus in Eastern Taiwan: Ten-year Experience From a Medical Center. Acta Paediatr Taiwan. 2007;48(6):332-6. PubMed PMID: 18437968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood scrub typhus in eastern Taiwan: ten-year experience from a medical center. AU - Yang,Shang-Hsien, AU - Ho,Yu-Huai, AU - Chu,Chia-Hsiang, AU - Chu,Shao-Yin, PY - 2008/4/29/pubmed PY - 2008/5/14/medline PY - 2008/4/29/entrez SP - 332 EP - 6 JF - Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi JO - Acta Paediatr Taiwan VL - 48 IS - 6 N2 - BACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is endemic in western Pacific Rims including Taiwan. Most reports have been concerned about mainly adult patients, whereas serologic surveys suggested that as many as one-half of cases of scrub typhus might be in children. METHODS: We conducted a retrospective study of childhood scrub typhus in our hospital from January 1997 to December 2006. Scrub typhus was diagnosed on the basis of serology tests or polymerase chain reaction (PCR) examination in fifteen children. RESULTS: Fever and chigger bite history were presented in all 15 cases, and eschar lesion was identified in 12 patients (80%). Nine (60%) patients had headache and six (40%) complained of abdominal pain. Three patients (20%) had meningoencephalitis, and two (13%) hemophagocytic syndrome were confirmed by bone marrow biopsy. One patient died of progressive acute respiratory distress syndrome (ARDS) and pulmonary hemorrhage. Myocarditis was revealed in autopsy. All surviving patient responded well to antibiotic therapy, and the average duration to defervescence after treatment was 1.8 days. CONCLUSIONS: We conclude that scrub typhus should be taken into consideration among patients of acute systemic febrile illness, especially those with suspected exposure history and typical skin lesion. Although most patients responded well to treatment, severe complications such as meningoencephalitis, interstitial pneumonia, acute respiratory distress syndrome, hemophagocytic syndrome, and myocarditis might lead to morbidity and mortality. SN - 1608-8115 UR - https://www.unboundmedicine.com/medline/citation/18437968/Childhood_scrub_typhus_in_eastern_Taiwan:_ten_year_experience_from_a_medical_center_ L2 - http://www.diseaseinfosearch.org/result/7025 DB - PRIME DP - Unbound Medicine ER -