Abstract
Introduction Scrub typhus is the most common ricketisial infection from the Indian subcontinent. It is caused by the organism Orienta tsutsugamushi inhabiting in trombiculid mites and transmitied to humans by the bite of these mites. The disease has a variety of clinical manifestations in children. As this is a common disease in our country so a retrospective study was conducted to study the clinical and laboratory profile and therapeutic outcomes of scrub typhus in children.
 Methodology A retrospective study was conducted at Sukraraj Tropical and Infectious disease Hospital, Teku, Kathmandu, Nepal after obtaining ethical clearance from Institutional Review Committee, and reviewing the medical records of serologically confirmed scrub typhus in children aged less than 14 years admitted to the hospital between March 2017 and February 2018. Relevant data were entered in excel spreadsheet and analyzed using SPSS 20.
 Result A total of 20 children were enrolled in the study. Of them 70% were female, with the mean age being 11.45 ± 3.1 years (range 3-14 years) and majority were from Dhading district (40%). All the children had fever; while there was cough, loss of appetite, rashes, headache, myalgia, arthralgia and hepatosplenomegaly in 45%, 90%, 20%, 55%, 35%, 35% and 30% of children respectively. There was thrombocytopenia in 50% of children; while hyponatremia, elevation of SGOT and SGPT was present in 30%, 70% and 55% of patients respectively. Azithromycin was used for treatment in 95% of children and all had defervescence of fever.
 Conclusion Scrub typhus should be suspected in children having prolonged fever with organomegaly, thrombocytopenia and elevated transaminases. Azithromycin can be used effectively in children diagnosed as scrub typhus.
Highlights
A retrospec ve study was conducted at Sukraraj Tropical and Infec ous disease Hospital, Teku, Kathmandu, Nepal a er obtaining ethical clearance from Ins tu onal Review Commi ee, and reviewing the medical records of serologically confirmed scrub typhus in children aged less than 14 years admi ed to the hospital between March 2017 and February 2018
Ricke sial diseases are established as re-emerging zoono c bacterial infec ons in the Indian subcon nent and are an important but o en under-recognised cause of febrile illness among children.[1]
Clinical manifesta ons include febrile illness with various symptoms ranging from headache, gastrointes nal upset, myalgia and self-limi ng state to variable severity like acute respiratory distress syndrome (ARDS), meningoencephali s, acute kidney injury (AKI), myocardi s leading to heart failure, hepa s and mul organ dysfunc on (MOD).[6]
Summary
Ricke sial diseases are established as re-emerging zoono c bacterial infec ons in the Indian subcon nent and are an important but o en under-recognised cause of febrile illness among children.[1] Among the wide range of ricke sial diseases, scrub typhus is one of the most commonly recognized diseases in the Asia-Pacific region.[2] Scrub typhus is a febrile disease endemic to the AsiaAustralia-Pacific region, where≈1 million cases occur annually.[3] Historically, the burden of scrub typhus in children has been high. The propor on of pediatric cases ranged from 50% to 74% in southern China and Taiwan respec vely while 52% of children were found to be seroposi ve in central Thailand.[4] Scrub typhus is the most commonly reported ricke sial infec on from the Indian subcon nent.[5] It is caused by the organism Orien a tsutsugamushi (O. tsutsugamushi). Clinical manifesta ons include febrile illness with various symptoms ranging from headache, gastrointes nal upset, myalgia and self-limi ng state to variable severity like acute respiratory distress syndrome (ARDS), meningoencephali s, acute kidney injury (AKI), myocardi s leading to heart failure, hepa s and mul organ dysfunc on (MOD).[6]
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