Scrub Typhus in Children at a Tertiary Care Hospital in Odisha: A Study on Clinical, Laboratory Profile, Complications and Its Outcome

Abstract

Background: To study the clinical profile, laboratory parameters, complications and outcome of scrub typhus in children. Methods: One hundred children with undiagnosed febrile illness admitted to our hospital from Aug 2014 to Nov 2014 were included in the study. All children were tested for scrub typhus using a commercial ELISA kit for specific IgM antibodies against Orientia tsutsugamushi. Results: Out of 100 children admitted to our hospital, only 50(50%) patients had positive IgM antibodies against O. tsutsugamushi. 30(60%) cases had fever of 5 to 10 days duration and 20(40%) cases had fever of more than 10 days duration. Vomiting with abdominal pain was reported in 20 (40%) cases, Lymphadenopathy in 18 (36%), hepatosplenomegaly in 35 (70%), generalized edema in 18 (36%) patients. Eschar was seen in 25(50%) patients. Most common abnormal laboratory parameters were raised SGOT, thrombocytopenia, raised bilirubin, raised CRP, leukocytosis and anemia. Most common complications were shock and electrolyte disturbances. Conclusion: In children Scrub typhus should be considered in the differential diagnosis of acute febrile illness associated with gastrointestinal symptoms, hepatosplenomegaly and lymphadenopathy .Prompt antibiotic treatment for scrub typhus should be given in cases with strong clinical suspicion to prevent morbidity and mortality.