Clinical profile of scrub typhus in children treated in a tertiary care hospital in eastern India

Background and objectiveOdisha in the eastern region of India has been witnessing an increased incidence of pediatric scrub typhus. The present study was undertaken to study the clinical profile, laboratory parameters, complications and efficacy to therapy in scrub typhus.DesignProspective observational study.Material and MethodsTotal 71 children up to 14 years of age who had fever for more than 5 days without an identifiable cause were included in the study. All suspected cases were tested with Weil-Felix test (OX-K ≥ 1:80 positive) and IgM antibody (ELISA) against Orientia tsutsugamushi. All IgM positive cases were further studied for response to Azithromycin therapy.ResultsTwenty six children were diagnosed with scrub typhus between July 2015 and December 2015. The age of patients ranged from eleven months to twelve years. Majority of patients (69.2%) were from rural areas. The common symptoms were fever, headache, hepatomegaly, lymphadenopathy and serosal effusions. Eschar was seen only in 30.7% of cases. Leucocytosis was seen in 76.9% of cases and 61.5% of cases had anicteric hepatitis. Commonest complications seen were hepatitis (61.5%) and pneumonia (38.4%). All cases responded well to azithromycin therapy.ConclusionsOur result showed that scrub typhus should be suspected in all cases of fever without an identifiable cause irrespective of age. Serosal effusions and anicteric hepatitis must raise the possibility of scrub typhus among clinicians.