Clinical Profile and Outcome of Pediatric Scrub Typhus: A Prospective Observational Study from Eastern India

Abstract

Abstract Background: Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi, which is transmitted to humans through the bite of infected chiggers (larval mites). While scrub typhus can affect individuals of all ages, including children, its clinical presentation and management in children may differ slightly from adults. There is a dearth of studies on pediatric scrub typhus from Eastern India. Materials and Methods: This prospective observational study was carried out in the pediatrics department of a tertiary care teaching hospital for 18 months. A total of 64 children aged <14 years were included. All the data related to demography, clinical and laboratory parameters, and treatment outcomes were recorded. Descriptive statistics were used to analyze and report the data. Results: The children affected most commonly belonged to the age group of 5–10 years (53.1%). Males were most commonly affected (61%). Fever was the presenting complaint in all but one case (98.4%). Other common symptoms were headache, vomiting, cough, seizure, and pain abdomen. Hepatomegaly was the most common physical finding seen in 84.4% of cases and Eschar in 75% of cases. Meningitis/encephalitis was the most common complication seen (43.8%). All children responded to the injection doxycycline, but one died (mortality rate 1.6%). Children who were cured did not show any sequelae at discharge. Conclusions: This study concludes that scrub typhus is a neglected rickettsial disease prevalent in our country. For timely diagnosis, treatment, and favorable outcome, a high degree of suspicion and knowledge about geographical distribution and clinical manifestations is important. This study can provide clues for primary care physicians to diagnose and treat scrub typhus early.