Clinical Profile of Scrub Typhus in Children: A hospital-based study
Akshit Sapehia1, Sandeep Kumar2, Harshita Thakur3
1Akshit Sapehia, Medical Officer Specialist, Paediatrics, Civil Hospital Shahpur
2Sandeep Kumar, Medical Officer Specialist, Paediatrics, Civil Hospital Amb
3Harshita Thakur, Medical Officer, CHC Sullah, Block Bhawarna, District Kangra
Abstract: Introduction: Scrub typhus is endemic in India due to the Tsutsugamushi Triangle. Increased farming area, animals, lesser education, outdoor cooking, and inadequate indoor sanitary facilities are the key sources of endemicity. The triangle is bounded by northern Australia, the Arabian Peninsula, and Japan. According to reports from South America, the Middle East, and Africa, identical diseases can exist outside the triangle. Unintentional hosts are people with this zoonotic disease. Methods: Data from hospital records of children who were admitted with fever to the paediatric ward of Dr. RPGMC, Tanda between January 2021 and December 2022 were collected using retrospective observational study methods. Children between the ages of one month and twelve years, of either gender, who were admitted to the paediatrics department's general ward and paediatric critical care unit met the inclusion criteria for this study (PICU). Results: All 50 children developed fever between 3 and 30 days, with a median of 7 days. Extremity edoema and face puffiness were found in 38 (76%) and 37 (74%) children, respectively. Cough was prevalent in 35 (70%) children. Vomiting and altered sensorium occurred in 30 (60%) and 29 (58%) youngsters, respectively. Other symptoms included oliguria, GI bleed, convulsions, and diarrhoea. 44 (88%) children had lymphadenopathy and 23 (46%) had eschar, the classic scrub typhus eschar. Axilla, genitalia, and inguinal skin folds had eschar. Popular, petechial, or erythematous rash, icterus, petechiae, and ecchymosis were discovered. Conclusion: A child with an acute febrile illness, maculopapular or erythematous rash, hepatosplenomegaly, lymphadenopathy, thrombocytopenia, and capillary leak should be considered for scrub typhus. Eschars in skin folds are important for diagnosis. Patients with clinical suspicion of scrub typhus should start azithromycin or doxycycline immediately without a serological test. Scrub typhus can occur in cities despite its prevalence in rural mite-exposed areas.
Keywords: Scrub typhus, Fever, Edema