Clinico-epidemiological and Outcome of Scrub Typhus in Paediatric Patients: An Observational Study from Odisha, IndiaCorrespondence Address :
Dr. Jyotiranjan Champatiray,
Shishubhavan, SVPPGIP, Chandni Chowk, Cuttack, Odisha, India.
Introduction: Scrub typhus is re-emerging as a common prolonged febrile illness in children with serious complication involving major organ systems. It is easily treatable yet treatment is challenging with respect to early identification of predictors of serious disease that greatly affects the outcome in this vulnerable population.
Aim: To study the clinical profile and analyse the complication and outcome of these patients.
Materials and Methods: This was a hospital-based prospective observational study. It was conducted in the Department of Paediatrics, SCB Medical College and Hospital, Cuttack from October 2017 to September 2019. All children with clinical features of scrub typhus were subjected to IgM scrub typhus test. All observational data were analysed by IBM SPSS software, v25.0 and Chi square test was used with p<0.05 as statistically significant.
Results: The majority of the patients among total of 196 (n=196) were found to be in the age group of 1-5 years of age, Majority were males (55%). Fever was universally present (100%). Eschar, the pathognomonic lesion of scrub typhus was found only in 47% of the patients. Acute hepatitis was the most frequent complication encountered (33%). Majority (88%) of the patients improved and were successfully discharged. A total of 61 (31%) patients, out of the 196 included in the study, required admission to ICU. Mortality was more marked in patients suffering from shock, acute hepatitis, Acute kidney Injury, meningoencephalitis and myocarditis and Multiple Organ Dysfunction Syndrome (MODS) (p<0.05).
Conclusion: Paediatric scrub typhus is quite common in the state of Odisha. Young age of presentation, presence of multi system involvement and delayed initiation of anti-rickettsial drugs due to delay in referral was also observed to be one of the poor prognostic factors.
Doxycycline, Eschar, Febrile children, Hepatitis
Date of Submission: Oct 24, 2020
Date of Peer Review: Dec 31, 2020
Date of Acceptance: Mar 30, 2021
Date of Publishing: Jul 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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