Study of Scrub Typhus - Clinical Profile, Laboratory Profile, Complications and Outcome

Abstract

Objectives: To study the diverse clinical features, laboratory manifestations, complications and outcome in children with scrub typhus. Materials and Methods: Children below 15 yrs of age, presenting with fever, during June'13 to-Dec'14. Scrub typhus was suspected when fever continued for more than 5 days, with 1) an eschar and 2) one or more of the following clinical features - rash, edema, hepato-splenomegaly, lymphadenopathy, capillary leak, tick bite or 3) positive IgM antibodies (rapid test immuno-chromatography). Results: Twenty five cases were seen with age ranging 2-15 years, with male preponderance. The common symptoms were fever, myalgia, edema, headache, gastrointestional related and cough. Eschar was found in 36% of patients. Common signs were hepatomegaly (72%), splenomegaly (56%), maculopapular rash (40%) and lymphadenopathy (28%). IgM antibody test for scrub typhus was positive in 64% of patients. Thrombocytopenia (56%) and anicteric hepatitis (48%) were commonest complications. There was no mortality. Conclusions: Any child presenting with features of hemorrhagic fever needs exclusion of other infections before scrub typhus is investigated for and once confirmed is treated with Doxycycline, to prevent complications including mortality.