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01-06-2018 | Original Article

Clinical profile and outcome of children with scrub typhus from Chennai, South India

Authors: Ramaswamy Ganesh, Natarajan Suresh, L. L. Pratyusha, Lalitha Janakiraman, Mani Manickam, A. Andal

Published in: European Journal of Pediatrics | Issue 6/2018

Abstract

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. We prospectively studied the clinico-laboratory profile and outcome of 358 children aged 1 day to 18 years diagnosed with scrub typhus from Chennai, South India. All children (100%) had fever. Eschar was seen in 67%. All children were treated with oral doxycycline and those with complications were treated with intravenous chloramphenicol/azithromycin. Rapid defervescence (within 48 h) after initiation of doxycline was seen in 306 (85%) and 52 (14.5%) developed complications. Multivariate logistic regression analysis revealed that children who had an elevated aspartate amino transferase (> 120 IU/L) and the presence of thrombocytopenia (platelet count less than 1 lac cells/mm³) at admission had high risk of developing complications. The overall mortality rate in this series was 0.8%.

Conclusion: Our 4-year study highlights the clinico-laboratory profile of Scrub typhus in children from Chennai, South India. Early recognition and prompt treatment reduces the complication and mortality.

What is Known:

• Scrub typhus is endemic to tsutsugamushi triangle, a geographical triangle extending from northern Japan in the east to Pakistan and Afghanistan in the west and northern Australia in the south.

• There is paucity of data regarding its clinico-laboratory profile in neonates as well as its predictors of outcome.

What is New:

• Children who had an elevated AST and the presence of thrombocytopenia at admission had high risk of developing complications.

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Title: Clinical profile and outcome of children with scrub typhus from Chennai, South India
Authors: Ramaswamy Ganesh
Natarajan Suresh
L. L. Pratyusha
Lalitha Janakiraman
Mani Manickam
A. Andal
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Pediatrics / Issue 6/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-018-3143-9

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