A study on clinical spectrum, complications and outcome of scrub typhus infection in children admitted in pediatric department of a tertiary care hospital in West Bengal, India

Abstract

Background: Scrub typhus is an important emerging etiology of febrile illnesses. Most of the studies of scrub typhus in literature have been carried out in adult population. The objective of the study is to obtain data on clinical spectrum, complications and outcome of scrub typhus infection in pediatric patients.Methods: This is a descriptive observational study, that includes 487 scrub typhus IgM ELISA positive children, conducted over a period of 36 months at Bankura Sammilani medical college & hospital, Bankura- a tertiary care government hospital in southern part of West Bengal. Data were collected in predesigned case record proforma and then analysed.Results: Highest number of cases were found among 2 to 6 years age group with male predominance, mostly from rural area & during the monsoon season. Fever, rash, headache, vomiting, cough-cold, myalgia, diarrhoea & body swelling were main presenting complaints. Hepatomegaly, lymphadenopathy, splenomegaly, eschar, pallor, edema were main examination findings. Anaemia, thrombocytopenia, leucocytosis, transaminitis were the important laboratory findings. Important complications were- hepatitis, bronchopneumonia, meningoencephalitis, pleural effusion, shock, myocarditis, acute kidney injury, respiratory failure, ARDS, MODS etc. Both azithromycin & doxycycline were effective for treatment of scrub typhus infection. Overall mortality was noted in 7.80%.Conclusions: Scrub typhus is an important re-emerging etiology of febrile illnesses in children. So, it should be kept in differentials of acute undifferentiated febrile illness in children. If diagnosed early, it is easy to treat with azithromycin and/or doxycycline and complications and mortality can be minimized significantly.