SCRUB TYPHUS IN CHILDREN AT A TERTIARY HOSPITAL IN NORTH INDIA: CLINICAL PROFILE AND COMPLICATIONS

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BHAT NOWNEET KUMAR; DHAR MINAKSHI; MITTAL GARIMA; SHIRAZI NADIA; RAWAT ANIL; KALRA BRAM PRAKASH; CHANDAR VIPAN; AHMAD SOHAIB

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Journal: IRANIAN JOURNAL OF PEDIATRICS Year:2014 | Volume:24 | Issue:4 Page(s): 387-392

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Title

SCRUB TYPHUS IN CHILDREN AT A TERTIARY HOSPITAL IN NORTH INDIA: CLINICAL PROFILE AND COMPLICATIONS

Author(s)

Keywords

SCRUB TYPHUS

MITE

ESCHAR

RASH

MENINGOENCEPHALITIS

Abstract

Objective: To study the clinical profile and complications of childhood scrub typhus.Methods: Prospective observational study of 66 children with scrub typhus, admitted to a tertiary hospital in north India, during the period between January 2011 and December 2012. The diagnosis was confirmed by serology.Findings: All children presented with fever. Other common symptoms were vomiting (56%), facial swelling (52%), cough (35%), abdominal pain (33%), breathlessness (29%) and decreased urine output (29%). High grade fever (>101 oF) was recorded in 91% of children. Other common signs were hepatomegaly, splenomegaly, edema, tender lymphadenopathy and hypotension, observed in 82%, 59%, 39%, 38% and 36% of cases, respectively. An eschar and a maculopapular rash each were observed in 20% of patients. Meningoencephalitis (30.3%), severe thrombocytopenia (27.2%), shock (25.8%), acute kidney injury (16.7%) and hepatitis (13.6%) were the most common complications observed in these children. Other common complications were acute respiratory distress syndrome, respiratory failure requiring ventilation, bronchopneumonia and myocarditis. Ninety percent of children became afebrile within 48 hours of initiating an appropriate antibiotic. Median time to defervescence was 22 hours. The overall mortality rate was 7.5%. Causes of death were refractory shock, meningoencephalitis, acute respiratory distress syndrome, bronchopneumonia, acute kidney injury and myocarditis.Conclusion: Pediatricians should keep a high index of suspicion for scrub typhus in any febrile child having a maculopapular rash, hepatosplenomegaly, tender lymphadenopathy, thrombocytopenia and features suggestive of capillary leak. Pending serological confirmation, empirical therapy with doxycycline or azithromycin should be started, as delay in treatment would result in life threatening complications.

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APA: Copy

BHAT, NOWNEET KUMAR, DHAR, MINAKSHI, MITTAL, GARIMA, SHIRAZI, NADIA, RAWAT, ANIL, KALRA, BRAM PRAKASH, CHANDAR, VIPAN, & AHMAD, SOHAIB. (2014). SCRUB TYPHUS IN CHILDREN AT A TERTIARY HOSPITAL IN NORTH INDIA: CLINICAL PROFILE AND COMPLICATIONS. IRANIAN JOURNAL OF PEDIATRICS, 24(4), 387-392. SID. https://sid.ir/paper/647063/en

Vancouver: Copy

BHAT NOWNEET KUMAR, DHAR MINAKSHI, MITTAL GARIMA, SHIRAZI NADIA, RAWAT ANIL, KALRA BRAM PRAKASH, CHANDAR VIPAN, AHMAD SOHAIB. SCRUB TYPHUS IN CHILDREN AT A TERTIARY HOSPITAL IN NORTH INDIA: CLINICAL PROFILE AND COMPLICATIONS. IRANIAN JOURNAL OF PEDIATRICS[Internet]. 2014;24(4):387-392. Available from: https://sid.ir/paper/647063/en

IEEE: Copy

NOWNEET KUMAR BHAT, MINAKSHI DHAR, GARIMA MITTAL, NADIA SHIRAZI, ANIL RAWAT, BRAM PRAKASH KALRA, VIPAN CHANDAR, and SOHAIB AHMAD, “SCRUB TYPHUS IN CHILDREN AT A TERTIARY HOSPITAL IN NORTH INDIA: CLINICAL PROFILE AND COMPLICATIONS,” IRANIAN JOURNAL OF PEDIATRICS, vol. 24, no. 4, pp. 387–392, 2014, [Online]. Available: https://sid.ir/paper/647063/en

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