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Scrub typhus in paediatric age group: A report from a tertiary care hospital

Year 2011, Volume: 3 Issue: 2, 1 - 7, 10.04.2011

Abstract

Background: Scrub typhus is a rickettsial disease endemic in many parts of India. It is a zoonosis spread by the bite of ticks and mites. Materials & Methods: The present retrospective study describes the clinical profile of eighteen pediatric scrub typhus cases who were hospitalized in a tertiary care hospital during the period of 21st January 2010 to 20th December 2010. In all the cases diagnosis was confirmed by Weil Felix test. Results: All children presented with fever. Eschar was present in 72% cases. 61% had abdominal pain and 44% had vomiting. Splenomegaly, hepatomegaly, lymphadenopathy, conjuctival congestion and cough were present in 88%, 72%, 61%, 34% and 28% respectively. Diarrhea and rash was present in 22% of children. Alanine transaminase, aspartate transaminase and alkaline phosphatase were elevated in 83%, 88% and 72% respectively. 34% had either hematuria or Proteinuria. 55% had thrombocytopenia. Hypoalbuminemia was detected in 72% cases. 88% had hepatic dysfunction, 22% had acute respiratory distress and 28% had hypotension. Chloramphenicol and doxycycline were the antibiotics used for treatment of the cases. All children responded well to antibiotics and there were no mortalities. Conclusion: Scrub typhus can lead to life threatening consequences in children if left undiagnosed and untreated. Therefore early detection of the disease and prompt treatment with the antibiotics can be life saving.

References

  • Seung-Hyun Lee, Dong-Min Kim, Young Shin Cho,Sung Ho Yoon, and Soo Kyoung Shim. Usefulness of Eschar PCR for Diagnosis of Scrub Typhus. Journal of Clinical Microbiology. 2006, 44: 1169–1171
  • Cohen J, Powderly WG, Berkley SF, Calandra T, Clumeck N, Finch RG. Scrub typhus. In: Hartman T, ed. Infectious diseases. 2nd ed. London: Mosby. 2004: 2322-23
  • Chin-Chou Wang, Shih-Feng Liu, Jien-Wei Liu, Yu-Hsiu Chung, Mao-Chang Su, and Meng-Chih Lin. acute respiratory distress syndrome in scrub typhus. Am. J. Trop. Med. Hyg; 2007, 76:1148– 1152
  • Yeon Joo Jeong, Suk Kim, Yeh Dae Wook, Jun Woo Lee, Kun-Il Kim, Sun Hee Lee. Scrub Typhus: Clinical, Pathologic, and Imaging Findings. RadioGraphics; 2007, 27:161–172
  • AR Chogle. Diagnosis and Treatment of Scrub Typhus – The Indian Scenario. JAPI 2010;58:11- 12
  • Mathai E, Rolain J M, Verghese G M, Abraham O C, Mathai D, Mathai M and Raoult D. outbreak of scrub typhus in southern india during the cooler months. Annals of the New york Academy of Sciences. 2003. 990: 359–364.
  • Chulapong Chanta , Suwalee Chanta. Clinical Study of 20 Children with Scrub Typhus at Chiang Rai Regional Hospital. J Med Assoc Thai. 2005, 88: 1867-72
  • Chang-Ting Huang, Hsin Chi, Hung-Chang Lee, Nan-Chang Chiu and Fu-Yuan Huang. Scrub typhus in children in a teaching hospital in eastern Taiwan, 2000-2005.South East Asian J Trop Med Public Health. 2009; 40: 789-794
  • Patil D, Bidari LH, Tikare N, Revankar VA. Profile of Rickettsial fever in children. Karnataka Pedicon 2006 - Conference Abstracts.Pediatric Oncall (Supplement 11);3.
  • Sanjeev Kumar Digra, Ghan Shyam Saini, Virender Singh, Sunil Dutt Sharma, Rajesh Kaul. Scrub Typhus in Children: Jammu Experience. JK Science. 2010;12:95-97
  • Berman SJ, Kundin WD. Scrub typhus in South Vietnam: a study of 87 cases. Ann Intern Med. 1973; 79:26–30
  • Coleman et al, Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Am J Trop Med Hyg. 2002; 67: 497-503.
  • Kriangsak Phimda, Siriwan Hoontrakul, Chuanpit Suttinont, Losuwanaluk, Sunee Chueasuwanchai et al. Doxycycline versus Azithromycin for Treatment of Leptospirosis and Scrub Typhus. Antimicrobial Agents and Chemotherapy. 2007; 51:3259–3263.
  • Saah AJ. Orientia tsutsugamushi (scrub typhus) In: Mandell GL, Bennett JE, Dolin R, eds. Principles and ed.Philadelphia, Pa: Churchill Livingstone, 2000; 2056–2057 disease. 5th
Year 2011, Volume: 3 Issue: 2, 1 - 7, 10.04.2011

Abstract

References

  • Seung-Hyun Lee, Dong-Min Kim, Young Shin Cho,Sung Ho Yoon, and Soo Kyoung Shim. Usefulness of Eschar PCR for Diagnosis of Scrub Typhus. Journal of Clinical Microbiology. 2006, 44: 1169–1171
  • Cohen J, Powderly WG, Berkley SF, Calandra T, Clumeck N, Finch RG. Scrub typhus. In: Hartman T, ed. Infectious diseases. 2nd ed. London: Mosby. 2004: 2322-23
  • Chin-Chou Wang, Shih-Feng Liu, Jien-Wei Liu, Yu-Hsiu Chung, Mao-Chang Su, and Meng-Chih Lin. acute respiratory distress syndrome in scrub typhus. Am. J. Trop. Med. Hyg; 2007, 76:1148– 1152
  • Yeon Joo Jeong, Suk Kim, Yeh Dae Wook, Jun Woo Lee, Kun-Il Kim, Sun Hee Lee. Scrub Typhus: Clinical, Pathologic, and Imaging Findings. RadioGraphics; 2007, 27:161–172
  • AR Chogle. Diagnosis and Treatment of Scrub Typhus – The Indian Scenario. JAPI 2010;58:11- 12
  • Mathai E, Rolain J M, Verghese G M, Abraham O C, Mathai D, Mathai M and Raoult D. outbreak of scrub typhus in southern india during the cooler months. Annals of the New york Academy of Sciences. 2003. 990: 359–364.
  • Chulapong Chanta , Suwalee Chanta. Clinical Study of 20 Children with Scrub Typhus at Chiang Rai Regional Hospital. J Med Assoc Thai. 2005, 88: 1867-72
  • Chang-Ting Huang, Hsin Chi, Hung-Chang Lee, Nan-Chang Chiu and Fu-Yuan Huang. Scrub typhus in children in a teaching hospital in eastern Taiwan, 2000-2005.South East Asian J Trop Med Public Health. 2009; 40: 789-794
  • Patil D, Bidari LH, Tikare N, Revankar VA. Profile of Rickettsial fever in children. Karnataka Pedicon 2006 - Conference Abstracts.Pediatric Oncall (Supplement 11);3.
  • Sanjeev Kumar Digra, Ghan Shyam Saini, Virender Singh, Sunil Dutt Sharma, Rajesh Kaul. Scrub Typhus in Children: Jammu Experience. JK Science. 2010;12:95-97
  • Berman SJ, Kundin WD. Scrub typhus in South Vietnam: a study of 87 cases. Ann Intern Med. 1973; 79:26–30
  • Coleman et al, Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Am J Trop Med Hyg. 2002; 67: 497-503.
  • Kriangsak Phimda, Siriwan Hoontrakul, Chuanpit Suttinont, Losuwanaluk, Sunee Chueasuwanchai et al. Doxycycline versus Azithromycin for Treatment of Leptospirosis and Scrub Typhus. Antimicrobial Agents and Chemotherapy. 2007; 51:3259–3263.
  • Saah AJ. Orientia tsutsugamushi (scrub typhus) In: Mandell GL, Bennett JE, Dolin R, eds. Principles and ed.Philadelphia, Pa: Churchill Livingstone, 2000; 2056–2057 disease. 5th
There are 14 citations in total.

Details

Primary Language English
Journal Section Original Articles
Authors

Amarabalan Rajendran

Publication Date April 10, 2011
Published in Issue Year 2011 Volume: 3 Issue: 2

Cite

APA Rajendran, A. (2011). Scrub typhus in paediatric age group: A report from a tertiary care hospital. Journal of Pediatric Sciences, 3(2), 1-7. https://doi.org/10.17334/jps.11450
AMA Rajendran A. Scrub typhus in paediatric age group: A report from a tertiary care hospital. Journal of Pediatric Sciences. April 2011;3(2):1-7. doi:10.17334/jps.11450
Chicago Rajendran, Amarabalan. “Scrub Typhus in Paediatric Age Group: A Report from a Tertiary Care Hospital”. Journal of Pediatric Sciences 3, no. 2 (April 2011): 1-7. https://doi.org/10.17334/jps.11450.
EndNote Rajendran A (April 1, 2011) Scrub typhus in paediatric age group: A report from a tertiary care hospital. Journal of Pediatric Sciences 3 2 1–7.
IEEE A. Rajendran, “Scrub typhus in paediatric age group: A report from a tertiary care hospital”, Journal of Pediatric Sciences, vol. 3, no. 2, pp. 1–7, 2011, doi: 10.17334/jps.11450.
ISNAD Rajendran, Amarabalan. “Scrub Typhus in Paediatric Age Group: A Report from a Tertiary Care Hospital”. Journal of Pediatric Sciences 3/2 (April 2011), 1-7. https://doi.org/10.17334/jps.11450.
JAMA Rajendran A. Scrub typhus in paediatric age group: A report from a tertiary care hospital. Journal of Pediatric Sciences. 2011;3:1–7.
MLA Rajendran, Amarabalan. “Scrub Typhus in Paediatric Age Group: A Report from a Tertiary Care Hospital”. Journal of Pediatric Sciences, vol. 3, no. 2, 2011, pp. 1-7, doi:10.17334/jps.11450.
Vancouver Rajendran A. Scrub typhus in paediatric age group: A report from a tertiary care hospital. Journal of Pediatric Sciences. 2011;3(2):1-7.