Title: An Observational Study of Clinical Features of Scrub Typhus

Authors: Dr Yazhini. E, Dr R.Ramanathan

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.144

Abstract

Objectives: Scrub typhus is a mite borne disease caused by Rickettsia tsutsugamushi. Because of the unpredictability and difficulty in diagnosis, it can sometimes be serious in pediatric age groups and fatality rate is as high as 30-35%. The aim of this study is to know the various clinical manifestations of scrub typhus in different pediatric age groups.

Methods: This prospective observational study was carried out in the children admitted in pediatric ward/pediatric ICU of our hospital with a total of 50 cases diagnosed positive for scrub typhus by ELISA.

Result: The study includes a total of 50 cases. Of these, 84% (42 cases) were from rural areas while 16% (8 cases) were urban. 56% (28 cases) were males and 44% (22 cases) were females. 54% (27 cases) were from school going age group (6-12 yrs). Among these cases, fever was seen in all children (100%) followed by hepatosplenomegaly (82%), eschar (76%), lymphadenopathy (60%), rash(26%), abdominal distension(6%), edema (4%) and seizures(2%).

Keywords: Rickettsia tsutsugamushi, scrub typhus.

References

  1. Rathi N Rathi A.Rickettsial infection: Indian Perspective – Review Article. Indian Pediatrics 2010;47:157-64
  2. Kulkarni A, Singhal T. Rickettsial Infection in children. IAP Textbook of Pediatrics 5th 535-539
  3. Udayan U, Dias M, Machoda S. A hospital based study of rickettsial diseases evidenced by Weil Felix test in a tertiary care hospital. CHRISMED J Health Res 2014; 1:150-3
  4. Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Rickettsial infections. In: Siberry GK, Dumler JS. Nelson textbook of pediatrics. 20th Pennyslvania: Saunders; 2007.p. 1289-301
  5. Palanivel S, Nedunchelian K, Poovazhagi V, Raghunandan R, Ramachandran R. Clinical Profile of Scrub Typhus in Children. Indian J Pediatrics 2012 79(11): 1459-1462
  6. Inamdar S, Thunga G et al. Study of clinical characteristics and treatment pattern of scrub typhus in tertiary care hospital. J. Pharm. Sci and Res. Vol 5, 2013, 107 – 110
  7. Rathi BN, Rathi AN et al. Rickettsial diseases in central india. Proposed clinical scoring system for early detection of spotted fever. Indian pediatrics 2011, 48: 867-72
  8. Rathi N, Rathi A. Rickettsial diseases in Indian context. Pediatric Infectious Disease 2013 5 (2): 64-68
  9. Dass R, Deka MN, Duwarah GS, Barman H, Hoquw R, Mili D, Barthakur D. Characteristics of pediatric scrub typhus during an outbreak in North Eastern Region of India: Pecularities in clinical presentation, Laboratory findings and complication. Indian J Pediatrics 2011 78(11):1365-1370
  10. K. Mahajan, J.M. Rolain, R. Kashyap, D. Bakshi, V. Sharma, B.S. Prasher. Scrub typhus in Himalayas. Emerg Infect Dis, 12 (2006), pp. 1590-1592
  11. M. Kim, S.W. Kim, S.H. Choi, N.R. Yun. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis, 10 (2010), p. 108
  12. Vivekanandan, A. Mani, Y.S. Priya, A.P. Singh, S. Jayakumar, S. Purty. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India, 58 (2010), pp. 24-28
  13. Kulkarni A. Childhood Rickettsiosis – Symposium on protocols old and new. Indian J Pediatrics 2011;78:81-87
  14. Murali N, Elizabeth M. Rickettsial Infection in South India. Indian Pediatrics 2001;38:1396-6
  15. Subbalaxmi MV, Chandra N, Teja VD, Lakshmi V, Rao MN, Raju YS. Scrub typhus – experience from a south indian tertiary care hospital. BMC infectious diseases 2012 12 (suppl 1):p77.

Corresponding Author

Dr Yazhini. E

Post Graduate, Department of Pediatrics,

Rajah Muthiah Medical College, Chidambaram