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Clinical profile of scrub typhus in children.
Indian J Pediatr. 2012 Nov; 79(11):1459-62.IJ

Abstract

OBJECTIVE

To study the clinical profile and outcome of scrub typhus cases admitted in an urban referral centre.

METHODS

This descriptive study describes the clinical profile of 67 children with scrub typhus, who were admitted in an urban referral centre(ICH & HC,Chennai) during the period between October 2010 and March 2011.The diagnosis was confirmed by IgM ELISA.

RESULTS

All children presented with fever. Eschar and rash were present in 46% and 35% cases, respectively. Cough, vomiting, altered sensorium and oliguria were present in 73%,59%,58% and 43%, respectively. Hepatosplenomegaly and pallor were the commonest findings encountered in more than 80% children. Other findings were edema, lymphadenopathy and icterus.Thrombocytopenia, elevated liver enzymes and leukocytosis were seen in 77%, 64% and 49% cases, respectively. Pleural effusion, ascites, shock and respiratory failure were seen in 61%, 47%,45%,34% cases, respectively. Acute renal failure, hepatic failure, multiorgan dysfunction syndrome (MODS), meningoencephalitis and acute respiratory distress syndrome(ARDS) were seen in 10%,10%,7%,6% and 4% cases, respectively. Doxycycline and azithromycin were the antibiotics used. The overall mortality rate was 11.94%. Causes of death were shock, ARDS, acute renal failure(ARF), MODS and disseminated intravascular coagulation(DIVC).

CONCLUSIONS

When a child presents with acute febrile illness, maculopapular or erythematous rash, hepatosplenomegaly, lymphadenopathy, thrombocytopenia and features suggestive of capillary leak, diagnosis of Scrub typhus must be considered and the child should be started on empirical therapy with doxycycline or azithromycin which is life saving.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Palanivel S
Department of Pediatrics, Institute of Child Health and Hospital for Children, Egmore, Chennai-8, Tamil Nadu, India. drpalanivel84@gmail.com
Nedunchelian K
No affiliation info available
Poovazhagi V
No affiliation info available
Raghunadan R
No affiliation info available
Ramachandran P
No affiliation info available

MeSH

Anti-Bacterial AgentsAntibodies, BacterialAzithromycinBiomarkersChildChild, PreschoolDoxycyclineEnzyme-Linked Immunosorbent AssayFemaleHospitals, UrbanHumansImmunoglobulin MIndiaInfantInfant, NewbornMaleOrientia tsutsugamushiScrub TyphusTertiary Care CentersTreatment Outcome

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

22374234

Citation

Palanivel, Sengottaiyan, et al. "Clinical Profile of Scrub Typhus in Children." Indian Journal of Pediatrics, vol. 79, no. 11, 2012, pp. 1459-62.
Palanivel S, Nedunchelian K, Poovazhagi V, et al. Clinical profile of scrub typhus in children. Indian J Pediatr. 2012;79(11):1459-62.
Palanivel, S., Nedunchelian, K., Poovazhagi, V., Raghunadan, R., & Ramachandran, P. (2012). Clinical profile of scrub typhus in children. Indian Journal of Pediatrics, 79(11), 1459-62. https://doi.org/10.1007/s12098-012-0721-0
Palanivel S, et al. Clinical Profile of Scrub Typhus in Children. Indian J Pediatr. 2012;79(11):1459-62. PubMed PMID: 22374234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical profile of scrub typhus in children. AU - Palanivel,Sengottaiyan, AU - Nedunchelian,Krishnamoorthi, AU - Poovazhagi,Varadharajan, AU - Raghunadan,Rangaswamy, AU - Ramachandran,Padmanabhan, Y1 - 2012/02/29/ PY - 2011/11/19/received PY - 2012/02/09/accepted PY - 2012/3/1/entrez PY - 2012/3/1/pubmed PY - 2013/11/13/medline SP - 1459 EP - 62 JF - Indian journal of pediatrics JO - Indian J Pediatr VL - 79 IS - 11 N2 - OBJECTIVE: To study the clinical profile and outcome of scrub typhus cases admitted in an urban referral centre. METHODS: This descriptive study describes the clinical profile of 67 children with scrub typhus, who were admitted in an urban referral centre(ICH & HC,Chennai) during the period between October 2010 and March 2011.The diagnosis was confirmed by IgM ELISA. RESULTS: All children presented with fever. Eschar and rash were present in 46% and 35% cases, respectively. Cough, vomiting, altered sensorium and oliguria were present in 73%,59%,58% and 43%, respectively. Hepatosplenomegaly and pallor were the commonest findings encountered in more than 80% children. Other findings were edema, lymphadenopathy and icterus.Thrombocytopenia, elevated liver enzymes and leukocytosis were seen in 77%, 64% and 49% cases, respectively. Pleural effusion, ascites, shock and respiratory failure were seen in 61%, 47%,45%,34% cases, respectively. Acute renal failure, hepatic failure, multiorgan dysfunction syndrome (MODS), meningoencephalitis and acute respiratory distress syndrome(ARDS) were seen in 10%,10%,7%,6% and 4% cases, respectively. Doxycycline and azithromycin were the antibiotics used. The overall mortality rate was 11.94%. Causes of death were shock, ARDS, acute renal failure(ARF), MODS and disseminated intravascular coagulation(DIVC). CONCLUSIONS: When a child presents with acute febrile illness, maculopapular or erythematous rash, hepatosplenomegaly, lymphadenopathy, thrombocytopenia and features suggestive of capillary leak, diagnosis of Scrub typhus must be considered and the child should be started on empirical therapy with doxycycline or azithromycin which is life saving. SN - 0973-7693 UR - https://www.unboundmedicine.com/medline/citation/22374234/Clinical_profile_of_scrub_typhus_in_children_ L2 - https://dx.doi.org/10.1007/s12098-012-0721-0 DB - PRIME DP - Unbound Medicine ER -