Scrub Typhus in Children at a Tertiary Care Center: Clinical Profile and Complications

Dr. Mohammed Kauser, Dr. K. Mahitha Krishna, Dr. M. Mahesh Kumar

Abstract: Background: To study the clinical profile and complications of childhood scrub typhus. Materials and Methods: The present study was a prospective hospital based study conducted in tertiary care hospital at Great Eastern Medical School and Hospital, Ragolu, Srikakulam, from April 2021 to September 2021 with 52 children. Results: Out of 52 children 65.3 % were males and 34.6% were females. All children presented with fever. Other common symptoms abdominal distension and pain (69%), Myalgia (38%) Vomitings (20%) decreasedurine output (7.6%). Eschar was found in 77% cases. Other common signs ascites (73%), fever more than 101oF (69%) Pain abdomen (61%). Thrombocytopenia, anaemia, pleural effusionwere the most common complications observed in these children. Other common complications were hepatitis, Cardiac dysfunction, ARDS, meningoencephalitis, AKI, myocarditis.90% children became afebrile within 48 hours of appropriate antibiotic. Overall mortality rate was 7.6 %. Cause of death were ARDS, myocarditis, PAH. Conclusion: Clinicians should keep a high suspicion for scrub typhus in any febrile child having hepatosplenomegaly, thrombocytopenia and features suggestive of capillary leak. Emperical therapy with doxycycline or azithromycin should be started as delay would result in life threatening complications.

Keywords: Scrub typhus, Mite, Eschar, ARDS, Meningoencephalitis