Abstract

Chaube D, Bhat N K, Chandar V, Rawat A

ABSTRACT

Objective: Scrub Typhus is a common rickettsial disease presenting as an acute febrile illness with multisystem involvement. Objective of this study is to evaluate the clinical features of scrub typhus in children brought to Himalayan Institute of Medical Sciences, Dehradun (a tertiary hospital, located in foot hills of Himalaya in north India). Method: Seventy nine children diagnosed with scrub typhus fulfilled the inclusion criteria and were analyzed in this study conducted over a period of one year. The diagnosis was confirmed by IgM ELISA test. Results: Out of 79 subjects, 52 were male and 27 were female with a male female ratio of 1.9:1. Fifty three (67.09%) resided in rural area while 26 (32.91%) resided in urban area. Most of the patients (91%) presented during the months of August to November. All of the patients presented with fever with the mean duration of fever on presentation was 9.07days. Other common symptoms observed were nausea (62.03%), anorexia (32.91%), abdominal pain (29.11%), headache (27.85%), breathing difficulty (25.32%), altered sensorium (21.52%) and convulsion (15.19%). The common signs observed were hepatomegaly (89.87%), splenomegaly (78.48%), pallor (51.90%), edema (43%), hypotension (22.78%), tachypnoea (21.52%), meningeal signs (21.52%), and eschar (17.72%). There were 3 deaths with an overall mortality of 3.8%. All these children presented late with manifestation of shock and multi organ dysfunctions. Conclusion: This study provides useful clinical and laboratory clues to help clinicians in early diagnosis of scrub typhus so as to institute appropriate antibiotic treatment to prevent the life threatening complications and mortality.