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J Pediatr Infect Dis 2017; 12(02): 110-113
DOI: 10.1055/s-0037-1599834
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Clinical Profile, Outcome, and Atypical Presentations of Scrub Typhus: Experience from a Tertiary Care Center in South India

Shobhana Sivathanu
1   Department of Paediatrics, ESIC Medical College & PGIMSR, Chennai, India
,
Aparna Jayaraman
1   Department of Paediatrics, ESIC Medical College & PGIMSR, Chennai, India
,
Saranya Parthasarathy
1   Department of Paediatrics, ESIC Medical College & PGIMSR, Chennai, India
,
Kumar Manickam
1   Department of Paediatrics, ESIC Medical College & PGIMSR, Chennai, India
,
Sowmya Sampath
1   Department of Paediatrics, ESIC Medical College & PGIMSR, Chennai, India
› Author Affiliations
Further Information

Publication History

20 October 2016

26 December 2016

Publication Date:
29 March 2017 (online)

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Abstract

Background The aim of this study was to describe the clinical profile and atypical presentations of scrub typhus in children aged younger than 12 years admitted to a tertiary care center in south India.

Materials and Methods A retrospective chart review of children diagnosed with scrub typhus from January 2014 to January 2015 was performed; the clinical features (including atypical presentations), laboratory parameters, and response to treatment were analyzed.

Results The majority of the cases was from urban areas and presented with gastrointestinal manifestations (25/31). Eschar was noted in 23 children (74%) and was typically found above the level of the umbilicus. All cases showed a rapid resolution with doxycycline. Atypical presentations included massive lung consolidation, epididymo-orchitis, secondary hemophagocytic lymphohistiocytosis, and “Kawasaki-like” disease. Infants in the group presented with low to moderate grade fever, significant hepatosplenomegaly, high C-reactive protein, and leukocytosis with lymphocytic preponderance. We propose that this tetrad of features, even in the absence of an eschar, should point to a possible diagnosis of scrub typhus in infants.

Conclusion Changes in typical presentation of pediatric scrub typhus present a continuing diagnostic challenge.

Keywords

scrub typhus - eschar - atypical features
 

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