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Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India.
Emerg Infect Dis. 2023 04; 29(4):711-722.EI

Abstract

Scrub typhus is an established cause of acute encephalitis syndrome (AES) in northern states of India. We systematically investigated 376 children with AES in southern India, using a stepwise diagnostic strategy for the causative agent of scrub typhus, Orientia tsutsugamushi, including IgM and PCR testing of blood and cerebrospinal fluid (CSF) to grade its association with AES. We diagnosed scrub typhus in 87 (23%) children; of those, association with AES was confirmed in 16 (18%) cases, probable in 55 (63%), and possible in 16 (18%). IgM detection in CSF had a sensitivity of 93% and specificity of 82% compared with PCR. Our findings suggest scrub typhus as an emerging common treatable cause of AES in children in southern India and highlight the importance of routine testing for scrub typhus in diagnostic algorithms. Our results also suggest the potential promise of IgM screening of CSF for diagnosis of AES resulting from scrub typhus.

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Authors

Damodar T
No affiliation info available
Singh B
No affiliation info available
Prabhu N
No affiliation info available
Marate S
No affiliation info available
Gowda VK
No affiliation info available
Lalitha AV
No affiliation info available
Dsouza FS
No affiliation info available
Sajjan SV
No affiliation info available
Kariyappa M
No affiliation info available
Kinhal UV
No affiliation info available
Prathyusha PV
No affiliation info available
Desai A
No affiliation info available
Thennarasu K
No affiliation info available
Solomon T
No affiliation info available
Ravi V
No affiliation info available
Yadav R
No affiliation info available

MeSH

HumansChildScrub TyphusAcute Febrile EncephalopathyOrientia tsutsugamushiIndiaMeningoencephalitisImmunoglobulin M

Pub Type(s)

Journal Article
Review
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36957990

Citation

Damodar, Tina, et al. "Association of Scrub Typhus in Children With Acute Encephalitis Syndrome and Meningoencephalitis, Southern India." Emerging Infectious Diseases, vol. 29, no. 4, 2023, pp. 711-722.
Damodar T, Singh B, Prabhu N, et al. Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India. Emerg Infect Dis. 2023;29(4):711-722.
Damodar, T., Singh, B., Prabhu, N., Marate, S., Gowda, V. K., Lalitha, A. V., Dsouza, F. S., Sajjan, S. V., Kariyappa, M., Kinhal, U. V., Prathyusha, P. V., Desai, A., Thennarasu, K., Solomon, T., Ravi, V., & Yadav, R. (2023). Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India. Emerging Infectious Diseases, 29(4), 711-722. https://doi.org/10.3201/eid2904.221157
Damodar T, et al. Association of Scrub Typhus in Children With Acute Encephalitis Syndrome and Meningoencephalitis, Southern India. Emerg Infect Dis. 2023;29(4):711-722. PubMed PMID: 36957990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India. AU - Damodar,Tina, AU - Singh,Bhagteshwar, AU - Prabhu,Namratha, AU - Marate,Srilatha, AU - Gowda,Vykuntaraju K, AU - Lalitha,A V, AU - Dsouza,Fulton Sebastian, AU - Sajjan,Sushma Veeranna, AU - Kariyappa,Mallesh, AU - Kinhal,Uddhava V, AU - Prathyusha,P V, AU - Desai,Anita, AU - Thennarasu,Kandavel, AU - Solomon,Tom, AU - Ravi,Vasanthapuram, AU - Yadav,Ravi, PY - 2023/3/23/entrez PY - 2023/3/24/pubmed PY - 2023/3/28/medline KW - India KW - Orientia tsutsugamushi KW - acute febrile encephalopathy KW - bacteria KW - central nervous system infections KW - encephalitis KW - meningitis/encephalitis KW - scrub typhus KW - vector-borne infections SP - 711 EP - 722 JF - Emerging infectious diseases JO - Emerg Infect Dis VL - 29 IS - 4 N2 - Scrub typhus is an established cause of acute encephalitis syndrome (AES) in northern states of India. We systematically investigated 376 children with AES in southern India, using a stepwise diagnostic strategy for the causative agent of scrub typhus, Orientia tsutsugamushi, including IgM and PCR testing of blood and cerebrospinal fluid (CSF) to grade its association with AES. We diagnosed scrub typhus in 87 (23%) children; of those, association with AES was confirmed in 16 (18%) cases, probable in 55 (63%), and possible in 16 (18%). IgM detection in CSF had a sensitivity of 93% and specificity of 82% compared with PCR. Our findings suggest scrub typhus as an emerging common treatable cause of AES in children in southern India and highlight the importance of routine testing for scrub typhus in diagnostic algorithms. Our results also suggest the potential promise of IgM screening of CSF for diagnosis of AES resulting from scrub typhus. SN - 1080-6059 UR - https://www.unboundmedicine.com/medline/citation/36957990/Association_of_Scrub_Typhus_in_Children_with_Acute_Encephalitis_Syndrome_and_Meningoencephalitis_Southern_India_ DB - PRIME DP - Unbound Medicine ER -