Current Scenario of Pediatric Rickettsial Diseases

Excerpt

Recent times have witnessed exponential rise in number of publications on Rickettsial diseases in India. This issue of the journal carries a study from southern part of India on Scrub Typhus [1]. Basically, two types of Rickettsial diseases are commonly seen in India i.e., Indian Tick Typhus (Spotted Fever Group, SFG) and Scrub Typhus (ST). Various studies indicate that ST is common type of Rickettsial disease in south, east and north India while both ST and SFG are seen in central India. There are clinically important differences between these two types of Rickettsioses. Rash is more commonly (98 %) seen [2] and of different nature in SFG while it is an uncommon (14–43 %) finding in ST [1, 2]. The rash in SFG is evolving in nature, it progresses from macular to maculopapular to purpuric to ecchymotic and leads to gangrene in untreated cases while it is maculopapular in ST. The vector for SFG (Tick) is visible to naked eye and hence evidence of direct vector exposure can be found in the form of tick bite/tick attachment or ticks on clothes or ticks in the vicinity of human dwellings while this important epidemiological diagnostic clue of vector exposure, is lacking in ST (Chiggers, being invisible to naked eye). Eschar, almost pathognomonic of Rickettsial disease, is found rarely in SFG but seen more commonly (7–97 %) in ST. …