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Clinical Profile and Therapeutic Response of Scrub Typhus in Children: A Recent Trend from Eastern India.
J Trop Pediatr. 2019 Apr 01; 65(2):139-146.JT

Abstract

OBJECTIVE

The aim of this study was to assess the clinico-laboratory parameters, complications and therapeutic responses in children with scrub typhus in Eastern India.

MATERIALS AND METHODS

In this prospective, observational study, all children (age, <12 years) with suspected scrub typhus with a compatible clinical scenario were enrolled consecutively over six months. Cases confirmed by means of a positive IgM serology or a positive Weil-Felix reaction (OXK = 1/80 or above) were administered enteral doxycycline (4.5 mg/kg/day).

RESULTS

Out of 94 recruited children, 61 had confirmed scrub typhus (mean age = 6.1 years, M:F = 1.1:1) with or without complications and having a considerably higher incidence of neurological presentation (meningoencephalistis n = 21, 34.4%). The most frequent manifestations included vomiting (n = 39, 63.9%), abdominal pain (n = 33, 54.1%), lymphadenopathy (n = 36, 59%), hepatosplenomegaly (n = 32, 52.5%), pedal edema (n = 32, 52.5%) and eschar formation (n = 30, 49.2%). Low hemoglobin levels, leukocytosis, thrombocytopenia, hypoalbuminemia, hyponatremia, increased liver enzymes and increased C-reactive protein were associated with delayed defervescence (>48 h).

CONCLUSION

Scrub meningoencephalitis, with a notably higher incidence, showed favorable therapeutic response. Prompt and empiric doxycycline therapy could be lifesaving.

Authors+Show Affiliations

Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pharmacology, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.Department of Pediatric Medicine, Institute of Postgraduate Medical Education & Research (I.P.G.M.E.& R.), 244, AJC Bose Road, Kolkata, India.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29800384

Citation

Basu, Suprit, et al. "Clinical Profile and Therapeutic Response of Scrub Typhus in Children: a Recent Trend From Eastern India." Journal of Tropical Pediatrics, vol. 65, no. 2, 2019, pp. 139-146.
Basu S, Saha A, Sarkar S, et al. Clinical Profile and Therapeutic Response of Scrub Typhus in Children: A Recent Trend from Eastern India. J Trop Pediatr. 2019;65(2):139-146.
Basu, S., Saha, A., Sarkar, S., Sinha, M. K., Das, M. K., Datta, R., Hazra, A., Datta Kanjilal, S., & Datta, S. (2019). Clinical Profile and Therapeutic Response of Scrub Typhus in Children: A Recent Trend from Eastern India. Journal of Tropical Pediatrics, 65(2), 139-146. https://doi.org/10.1093/tropej/fmy027
Basu S, et al. Clinical Profile and Therapeutic Response of Scrub Typhus in Children: a Recent Trend From Eastern India. J Trop Pediatr. 2019 Apr 1;65(2):139-146. PubMed PMID: 29800384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Profile and Therapeutic Response of Scrub Typhus in Children: A Recent Trend from Eastern India. AU - Basu,Suprit, AU - Saha,Arpan, AU - Sarkar,Sumantra, AU - Sinha,Malay Kumar, AU - Das,Mrinal Kanti, AU - Datta,Ranjabati, AU - Hazra,Avijit, AU - Datta Kanjilal,Sumana, AU - Datta,Supratim, PY - 2018/5/26/pubmed PY - 2020/3/17/medline PY - 2018/5/26/entrez KW - doxycycline KW - meningoencephalitis KW - scrub KW - typhus SP - 139 EP - 146 JF - Journal of tropical pediatrics JO - J Trop Pediatr VL - 65 IS - 2 N2 - OBJECTIVE: The aim of this study was to assess the clinico-laboratory parameters, complications and therapeutic responses in children with scrub typhus in Eastern India. MATERIALS AND METHODS: In this prospective, observational study, all children (age, <12 years) with suspected scrub typhus with a compatible clinical scenario were enrolled consecutively over six months. Cases confirmed by means of a positive IgM serology or a positive Weil-Felix reaction (OXK = 1/80 or above) were administered enteral doxycycline (4.5 mg/kg/day). RESULTS: Out of 94 recruited children, 61 had confirmed scrub typhus (mean age = 6.1 years, M:F = 1.1:1) with or without complications and having a considerably higher incidence of neurological presentation (meningoencephalistis n = 21, 34.4%). The most frequent manifestations included vomiting (n = 39, 63.9%), abdominal pain (n = 33, 54.1%), lymphadenopathy (n = 36, 59%), hepatosplenomegaly (n = 32, 52.5%), pedal edema (n = 32, 52.5%) and eschar formation (n = 30, 49.2%). Low hemoglobin levels, leukocytosis, thrombocytopenia, hypoalbuminemia, hyponatremia, increased liver enzymes and increased C-reactive protein were associated with delayed defervescence (>48 h). CONCLUSION: Scrub meningoencephalitis, with a notably higher incidence, showed favorable therapeutic response. Prompt and empiric doxycycline therapy could be lifesaving. SN - 1465-3664 UR - https://www.unboundmedicine.com/medline/citation/29800384/Clinical_Profile_and_Therapeutic_Response_of_Scrub_Typhus_in_Children:_A_Recent_Trend_from_Eastern_India_ L2 - https://academic.oup.com/tropej/article-lookup/doi/10.1093/tropej/fmy027 DB - PRIME DP - Unbound Medicine ER -