Affiliation:
1. Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry 605006, India
2. Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry 605006, India
Abstract
SUMMARY
Scrub typhus is being reported as the most common cause of childhood meningoencephalitis (ME) in India. Hence, we planned to estimate the proportion of scrub typhus infection among children aged 1 month to 12 years with the clinical diagnosis of ME and to evaluate their demographic, clinical and laboratory characteristics. This cohort study was conducted in the Department of Pediatrics of a tertiary care teaching hospital in south India. One hundred and twenty-seven consecutive children aged 1 month to 12 years with the clinical diagnosis of ME were the participants. Their socio-demographic factors, clinical details, laboratory reports and outcomes were analyzed. The etiological agent was identified in 71 (56%) children. Orientia tsutsugamushi (Scrub typhus) was the most common infection (24.4%), of all children with ME. Children aged ≥5 years were frequently affected by scrub typhus ME. Eschar, capillary leak, hepatomegaly and splenomegaly were the predominant clinical features of scrub typhus ME. Thrombocytopenia and deranged liver function tests were common in scrub typhus ME. To conclude, Orientia tsutsugamushi was the most common organism identified in our study. Prompt recognition of some tell-tale clinical signs of scrub typhus (such as eschar, thrombocytopenia and hepatosplenomegaly), and timely initiation of antibiotics would lead to better outcomes as evident from the study.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Pediatrics, Perinatology and Child Health
Reference29 articles.
1. Global, Regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017;GBD Causes of Death Collaborators;Lancet,2018
2. Consensus guidelines on evaluation and management of suspected acute viral encephalitis in children in India;Sharma;Indian Pediatr,2012
3. DHR-ICMR guidelines for diagnosis & management of rickettsial diseases in India;Rahi;Indian J Med Res,2015
4. Rickettsioses in children – a review;Sood;Indian J Pediatr,2020
5. Scrub typhus leading to acute encephalitis syndrome, Assam, India;Khan;Emerg Infect Dis,2017