SCRUB TYPHUS IN CHILDREN: A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL OF RURAL WEST BENGAL, INDIA

Abstract

Scrub typhus is an emerging acute undifferentiated febrile illness (AUFI) among children, particularly in rural West Bengal. Due to the lack of gold standard diagnostic tests, and lack of awareness among healthcare personnel, it leads to delay in diagnosis and specic treatment which leads to several complications and even death. In this perspective, with the hope to know better, this study was done to evaluate clinical features, complications, laboratory proles and outcome of scrub typhus in the paediatric population. AIMS AND OBJECTIVES:To study clinical features, complications, laboratory proles and outcomes of scrub typhus in children. MATERIALANDMETHODS:Thisretrospective studywas conducted in theDepartment ofPaediatrics ofBankuraSammilaniMedicalCollege and Hospital(BSMCH),Bankura,India.Data of 75 childrenwhowere found to be IgMpositive toOrientia tsutsugamushi, aged onemonth to 12 yearswere collectedfromthe case registermaintainedinourunitfromJune2020toAugust2021andwere analysedbyEpiInfo,version3.5.1,software. RESULTS: Fever was the most common presenting symptoms seen in 100% (n=75) of cases. Other common signs and symptoms were vomiting (n=22,29.3%), pain abdomen (n=15,20%), cough(n=22,29.3%), myalgia (n=12,16%), headache (n=12,16%), convulsions (n=8,10.7%), pallor (n=25,33.3%), facial pufness (n=28,37.3%), oedema (n=12,16%), eschar (n=20,26.7%), hepatomegaly (n=45,60%) and splenomegaly (n=42,56%). Among laboratory parameters, anaemia (n=72,96%), leucocytosis (n=31,41.3%), thrombocytopenia (n=43,57.3%), raised alanine aminotransferase (n=49,65.3%), aspartate aminotransferase (n=46,61.3%) and hypoalbuminemia (n=31,41.3%) were observed. Meningoencephalitis was present in 10.7% (n=8) of cases. CONCLUSION: A high index of suspicion and abnormal laboratory ndings will help physicians in the timely diagnosis of scrub typhus and initiate anti-scrub treatment early, thereby preventing complications and minimising fatality.