Clinical profile and complications: scrub typhus in children at a tertiary hospital in south India, Nellore

Abstract

Background: Rickettsial diseases, including scrub typhus, are emerging across the Asia-Pacific region as a significant source of acute undifferentiated febrile disease. The purpose of the research is to study the clinical profile, symptoms, and results of cases of scrub typhus admitted to rural medical colleges.Methods: From November 2019 to August 2020, this prospective descriptive research was performed at Narayana Medical College, Nellore, Andhra Pradesh, India. Children who were scrub typhus-positive by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) were tested.Results: 164 children (more than 40 percent of fever cases) were scrub typhus-positive during the study time. Many of the children had a fever. 84.15 percent, 49.40 percent, 37.20 percent, 56.10 percent, and 25 percent respectively saw high-grade fever, chills, vomiting, cough, and headache. In 63.41 percent of children, Eschar was shown. The typical findings were lymphadenopathy (68.30 percent) and hepatomegaly (more than 57 percent). In 47.56 percent, 25.60 percent, 39.63 percent, and 37.19 percent, shock, respiratory failure, pleural effusion, and ascites were observed. Popular lab results were anemia (70.12 percent) and thrombocytopenia (74.40 percent). Complications were recorded in shock (47.56 percent), ARDS (10.36 percent), meningoencephalitis (7.32 percent), and MODS (1.22 percent). The complications were treated with doxycycline (51.21 percent), azithromycin (12.80 percent), and both drugs (35.97 percent) were used to treat the complications.Conclusions: When a child presents with acute febrile illness, hepatosplenomegaly, lymphadenopathy, anemia with thrombocytopenia, and features suggestive of capillary leak diagnosis of scrub typhus must be considered. Doxycycline or azithromycin, proper fluid boluses, inotropes, and O2 through Jackson-Rees circuit are life-saving for scrub typhus and its complications.