Abstract
Objectives: Scrub typhus is an acute, febrile, exanthematous illness. This disease is underdiagnosed in India due to its non-specific and varied clinical presentation, low index of suspicion among clinicians, and lack of diagnostic facilities. This study was carried out to know the seroprevalence of scrub typhus in children with PUO and to compare a rapid test with IgM enzyme-linked immunosorbent assay (ELISA) for the diagnosis of scrub typhus.
 Methods: This cross-sectional analytical study was conducted for a period of 1 year. The study population comprised mainly 280 young children attending pediatric OP and in patients admitted to a tertiary care teaching hospital with fever and related symptoms. The serum samples were tested for Weil-Felix reaction, IgM ELISA, and rapid card test.
 Results: The mean age group of the study population was 7–9 years, of which 20 cases were positive. The major predisposing factor for scrub typhus infection was vegetation around houses. The sensitivity and specificity of both, card test and IgM ELISA, were 100%.
 Conclusion: In this study, 7.1% of febrile children were positive for scrub typhus. Leptospirosis, dengue, and typhoid were the common coinfections found in scrub typhus, positive children. Early identification of cases and treatment at the earliest will prevent complications.
Highlights
All over the world, fever in children is one of the most common reasons for parents to seek medical care
Gender-wise analysis of the study population was recorded as 62.1% and 37.9% among male and female children, respectively
The prevalence of scrub typhus varies from 8% to 60% in different countries [8], and in this study, we described the prevalence and clinical profile of this illness in the pediatric patients at a tertiary hospital in South India
Summary
Fever in children is one of the most common reasons for parents to seek medical care It remains among the most challenging clinical situations in diagnosis for health-care providers to approach and often involves referral to subspecialists. In Southeast Asia, scrub typhus infection is one important cause of acute undifferentiated fever This mite borne illness is caused by the bacterium belonging to Rickettsia family, Orientia tsutsugamushi [1]. This infection is grossly underdiagnosed in India because of its non-specific clinical presentation, low index of suspicion among clinicians, limited awareness about the disease, and lack of diagnostic facilities [2]. The disease starts with non-specific symptoms, it may lead to high mortality (35−60%) if diagnosis or appropriate therapy is delayed [3]
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