scholarly journals A study on clinical profile, complications and outcome of scrub typhus in south Indian children

2017 ◽  
Vol 4 (3) ◽  
pp. 848
Author(s):  
J. Balaji ◽  
P. Punitha ◽  
B. Ramesh Babu ◽  
K. S. Kumaravel
Keyword(s):  
Scrub Typhus ◽  
Febrile Illness ◽  
Clinical Profile ◽  
Asia Pacific ◽  
High Grade Fever ◽  
Indian Children ◽  
College Hospital ◽  
Medical College ◽  
South Indian ◽  
Life Saving

Background: Rickettsial diseases including Scrub Typhus are emerging as an important cause of acute undifferentiated febrile illness throughout the Asia-Pacific region. The objectives of the study are to study the clinical profile, complications and outcome of Scrub Typhus cases admitted in rural medical college.Methods: This prospective descriptive study was done at Government Dharmapuri Medical College Hospital, Tamilnadu, between Jul’2015 and Jan’2016. The children who were positive for Scrub Typhus by IgM Elisa were analyzed.Results: During the study period, 151 children (40% of fever cases) were positive for Scrub Typhus. All the children were presented with fever. High-grade fever, chills, vomiting, cough, head ache, were seen in 83%, 41%, 57%, 56% and 32% respectively. 54% of children had lethargy and 10% children brought with convulsions to hospital. Eschar was seen in 68% of children. Lymphadenopathy (70%) and hepatosplenomegaly (more than 56%) were common findings. Shock, respiratory distress, pleural effusion and ascites were seen in 46%, 36%, 40% and 37% respectively. Anemia (74%) and thrombocytopenia (81%) were common lab findings. Shock (46%), ARDS (12%), Meningoencephalitis (10%) and MODS (1.3%) were complications reported. Doxycycline (53%), Azithromycin (11%) and both drugs (36%) were used. Along with fluids, Dopamine (38%), nor-adrenaline (12%), Oxygen through Jackson-Rees Circuit (28%), Non-invasive ventilation (9%) was needed to treat the complications.Conclusions: When a child presents with acute febrile illness, hepatospleenomegaly, lymphadenopathy, anemia with thrombocytopenia and features suggestive of capilary leak diagnosis of Scrub Typhus must be considered. Doxycycline or Azithromycin, proper fluid boluses, Inotropes and O2 through Jackson-Rees Circuit are life saving for scrub typhus and its complications.

scholarly journals Clinical profile and complications: scrub typhus in children at a tertiary hospital in south India, Nellore

2021 ◽  
Vol 8 (3) ◽  
pp. 545
Author(s):  
E. Kishore ◽  
S. V. S. Sreedhar
Keyword(s):  
Scrub Typhus ◽  
Febrile Illness ◽  
Tertiary Hospital ◽  
Immunoglobulin M ◽  
Clinical Profile ◽  
Asia Pacific ◽  
Enzyme Linked Immunosorbent Assay ◽  
High Grade Fever ◽  
Medical College ◽  
Life Saving

Background: Rickettsial diseases, including scrub typhus, are emerging across the Asia-Pacific region as a significant source of acute undifferentiated febrile disease. The purpose of the research is to study the clinical profile, symptoms, and results of cases of scrub typhus admitted to rural medical colleges.Methods: From November 2019 to August 2020, this prospective descriptive research was performed at Narayana Medical College, Nellore, Andhra Pradesh, India. Children who were scrub typhus-positive by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) were tested.Results: 164 children (more than 40 percent of fever cases) were scrub typhus-positive during the study time. Many of the children had a fever. 84.15 percent, 49.40 percent, 37.20 percent, 56.10 percent, and 25 percent respectively saw high-grade fever, chills, vomiting, cough, and headache. In 63.41 percent of children, Eschar was shown. The typical findings were lymphadenopathy (68.30 percent) and hepatomegaly (more than 57 percent). In 47.56 percent, 25.60 percent, 39.63 percent, and 37.19 percent, shock, respiratory failure, pleural effusion, and ascites were observed. Popular lab results were anemia (70.12 percent) and thrombocytopenia (74.40 percent). Complications were recorded in shock (47.56 percent), ARDS (10.36 percent), meningoencephalitis (7.32 percent), and MODS (1.22 percent). The complications were treated with doxycycline (51.21 percent), azithromycin (12.80 percent), and both drugs (35.97 percent) were used to treat the complications.Conclusions: When a child presents with acute febrile illness, hepatosplenomegaly, lymphadenopathy, anemia with thrombocytopenia, and features suggestive of capillary leak diagnosis of scrub typhus must be considered. Doxycycline or azithromycin, proper fluid boluses, inotropes, and O2 through Jackson-Rees circuit are life-saving for scrub typhus and its complications.

scholarly journals PREVALANCE OF PULMONARY & RADIOLOGICAL MANISFESTATIONS IN SCRUB TYPHUS PATIENTS IN INDEX MEDICAL COLLEGE, INDORE

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Shiv Kumar Pandey ◽  
Vishal Malviya ◽  
Kumar Girendra ◽  
Abhijeet Khandelwal
Keyword(s):  
Scrub Typhus ◽  
Lower Lobe ◽  
Febrile Illness ◽  
Research Centre ◽  
Igg Antibody ◽  
Serum Electrolytes ◽  
College Hospital ◽  
Medical College ◽  
Laboratory Investigations ◽  
Rule Out

Background & Method: 20 patients with scrub typhus who visited Index Medical College Hospital & Research Centre, Indore. Diagnosis of scrub typhus was made from blood samples based on serology (scrub typhus IgM / IgG antibody). We observed the following symptoms – eschar, cough, SOB, fever, chest pain, nausea /vomiting, abdominal pain, seizures, & the various laboratory investigations were done (TLC, ESR, S.CREATINE, LFT, SERUM ELECTROLYTES ETC.). CXR (PA / AP) were analysed on the basis of the presence, location and zonal predilection for consolidations, reticulo nodular shadows, hilar shadows and lower lobe haziness. Conclusion: Pulmonary manifestation of Scrub typhus is uncommon. But can be fatal, particulary in the form of ARDS. Antibiotic therapy may prove beneficial in initial phase. In acute febrile illness (SCRUB TYPHUS), pulmonary symptoms and radiological menifestations should be rule out in early stages to prevent the mortality. Keywords: Prevalance, Pulmonary, Radiological & Scrub Typhus.

scholarly journals A study of clinical and laboratory profile of scrub typhus in children in a tertiary hospital in South India

2017 ◽  
Vol 4 (2) ◽  
pp. 482
Author(s):  
Radha Kumar ◽  
Purusothaman Srinivasan
Keyword(s):  
Tamil Nadu ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Tertiary Hospital ◽  
Response To Therapy ◽  
Acute Febrile Illness ◽  
College Hospital ◽  
Medical College ◽  
Laboratory Profile ◽  
High Index Of Suspicion

Background: Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi. The present study was conducted to study the clinical features, laboratory profile, complications and response to therapy among children suffering from scrub typhus in a tertiary health care institution of Tamil Nadu, India.Methods: The study was conducted at Saveetha Medical College Hospital, Tamil Nadu, India. Duration of the study was from August to December, 2015 in the Department of Pediatrics. Children with clinically suspected Scrub typhus were subjected to detailed clinical examination and investigation. Diagnosis of scrub typhus was confirmed by IgM ELISA. Results: 34 patients were diagnosed as suffering from scrub typhus. Common symptoms noted were fever, headache, cough and cold, chills, rigor, myalgia and vomiting. The common complications noted were thrombocytopenia in 16 children (47%) and features of meningoencephalitis and hepatitis were present in 2 children (5.8%). Eschar was identified in 24 (70.5%) patients. Mixed infection was seen in 4 (11.7%) children who had concurrent culture positive Urinary Tract Infection.   Conclusions: Scrub typhus is an acute febrile illness which requires high index of suspicion for early diagnosis, monitoring of the clinical and laboratory parameters and prompt treatment which may help in complete cure without further complications and morbidity.  

scholarly journals Clinical Profile and Outcome of Patients with Dengue Syndrome in Hospital Care

2011 ◽  
Vol 12 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Hanif Mohammad ◽  
Devendra Nath Sarkar ◽  
M Robed Amin ◽  
A Basher ◽  
T Ahmed
Keyword(s):  
Severity Of Illness ◽  
Febrile Illness ◽  
Dengue Shock Syndrome ◽  
Clinical Profile ◽  
Health Concern ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Abdominal Symptoms ◽  
Male Female Ratio

Dengue is a viral febrile illness, which has become a major international public health concern including Bangladesh, spectrum of illness ranging from dengue fever (DF) to life threatening dengue haemorrhagic fever (DHF), dengue shock syndrome (DSS) and ultimately death. The clinical profiling and outcome during epidemic dengue outbreak was observed in Dhaka Medical College Hospital in 2000 to 2001. One hundred and fifty patients were systematically observed. Male female ratio was 5:1 with severity of illness in younger patients. Hundred percent patients had fever with 83% having generalized weakness. The severe cases(DHF) were having sudden sustained temperature of 103 degree farenheight. Majority have abdominal symptoms(>80%) while 10% had respiratory only. Sixty percent have hepatomegaly while 40 % spleenomealy while 80% of DHF had ascites. Above 75% cases of Dengue haemorhagic fever had positive tourniquet test while melaena was the commonest mucosal bleeds. No fatality was observed in this study although variability of discharge was seen in different groups. Keyword: Clinical, Profile, Outcome, Dengue, Hospital DOI: http://dx.doi.org/10.3329/jom.v12i2.6733 JOM 2011; 12(2): 131-138

Clinical Profile of Scrub Typhus Meningoencephalitis among South Indian Children

2017 ◽  
Author(s):  
Narayanasamy Dinesh Kumar ◽  
Thirunavukkarasu Arun Babu ◽  
Vijayasankar Vijayadevagaran ◽  
Shanthi Ananthakrishnan ◽  
Devi Kittu
Keyword(s):  
Scrub Typhus ◽  
Clinical Profile ◽  
Indian Children ◽  
South Indian

scholarly journals Scrub typhus: a hospital-based study in the northern districts of West Bengal, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2403
Author(s):  
Sanjay Kumar Mallick ◽  
Santanu Hazra ◽  
Tanmoy Nandi ◽  
Arunabha Sarkar
Keyword(s):  
Case Fatality Rate ◽  
West Bengal ◽  
Scrub Typhus ◽  
Case Fatality ◽  
Febrile Illness ◽  
Asia Pacific ◽  
Enzyme Linked Immunosorbent Assay ◽  
Acute Febrile Illness ◽  
Fatality Rate ◽  
Serological Tests

Background: Scrub typhus caused by Orientia tsutsugamushi, is a mite-borne zoonotic acute febrile illness. Geographically, it is confined to the Asia-Pacific region and important re-emerging infection in India. Clinical diagnosis of scrub typhus from other acute febrile illness is very difficult due to nonspecific symptoms and the relative absence of eschar in the Indian population. Case fatality rate varies from 30-70% depending on the clinical suspicion, delay in diagnosis and treatment. Antibody-based serological tests are the mainstay of diagnosis. IgM enzyme-linked immunosorbent assay (ELISA) against O. tsutsugamushi is helpful for the diagnosis of scrub typhus within the first week of illness.Methods: The aim of the study was to determine the prevalence of the disease in Northern districts of West Bengal, India using IgM ELISA.Results: Out of 577 serum samples tested 10.05% were positive for IgM antibodies. Majority of cases were below 40 years of age with higher prevalence in female patients. The disease showed a seasonal trend with a peak during the monsoon and later months. The case fatality rate among ELISA positive cases was 32.76%.Conclusions: Significant seropositivity against scrub typhus among cases of acute febrile illness with relatively higher mortality indicates that scrub typhus should be included in the differential diagnosis and confirmed by IgM ELISA.

scholarly journals Differentiating Scrub Typhus, Dengue Fever and Typhoid Fever in Indian Children Presenting with Acute Febrile Illness

2020 ◽  
Vol 40 (2) ◽  
pp. 93-99
Author(s):  
Saheli Misra Chatterjee ◽  
Suman Mondal ◽  
Kaushik Mukhopadhyay ◽  
Niloy Kumar Das
Keyword(s):  
Dengue Fever ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Indian Children ◽  
Diagnostic Dilemma ◽  
Female Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Introduction: The disease spectrum of dengue, scrub typhus and typhoid presenting as acute febrile illness is often a diagnostic dilemma to the clinician. The purpose of this study is to compare the clinical features and laboratory parameters of children suffering from typhoid, dengue and scrub typhus and use these parameters in early identification of scrub typhus before conclusion is made from serological diagnosis. Methods: A retrospective observational analytical study was conducted among children presenting with acute febrile illness in a tertiary care level hospital. Over the period of one year 113 cases were identified of which 39 were dengue, 44 were typhoid and 30 were scrub typhus. Results: The mean age of the children was 7.45 ± 2.98 years, median was eight with an interquartile range of six to ten years. The male to female ratio was 1.3:1. Symptoms of vomiting (61.54%), headache (46.15%) and hepatomegaly (47.37%) were significantly higher among children with dengue fever. A significantly higher number of children with scrub typhus fever had temperature above 40°C. The incidence of low haemoglobin, raised C reactive protein, raised ALT and low albumin levels were significantly higher in them. Children with acute febrile illness having temperature > 40°C, absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to suffer from scrub typhus with relative probability ratio (RPR) of 25.68 and 10.57 respectively (p < 0.001). Children with WBC < 5000/mm3 were more likely to be suffering from dengue with RPR of 10.60 (p < 0.001). Conclusion: Children with acute febrile illness with temperature > 40°C and absolute neutrophil/lymphocyte ratio > 2 early in the illness were more likely to be suffering from scrub typhus.

scholarly journals Ecological and microbiological diversity of chigger mites, including vectors of scrub typhus, on small mammals across stratified habitats in Thailand

2019 ◽  
Author(s):  
Kittipong Chaisiri ◽  
A. Christina Gill ◽  
Alexandr A. Stekolnikov ◽  
Soawapak Hinjoy ◽  
John W. McGarry ◽  
...  
Keyword(s):  
Species Richness ◽  
Scrub Typhus ◽  
Bacterial Pathogen ◽  
Febrile Illness ◽  
Asia Pacific ◽  
Habitat Types ◽  
Widespread Species ◽  
Human Land Use ◽  
Β Diversity ◽  
Α Diversity

AbstractScrub typhus, caused by a bacterial pathogen (Orientia spp.), is a potentially life-threatening febrile illness widely distributed in the Asia-Pacific region and is emerging elsewhere. The infection is transmitted by the larval stage of trombiculid mites (“chiggers”) that often exhibit low host specificity. Here, we present an analysis of chigger ecology for 38 species sampled from 11 provinces of Thailand and microbiomes for eight widespread species. In total, >16 000 individual chiggers were collected from 1 574 small mammal specimens belonging to 18 species across four horizontally-stratified habitat types. Chigger species richness was positively associated with higher latitudes, dry seasonal conditions, and host maturity; but negatively associated with increased human land use. Human scrub typhus incidence was found to be positively correlated with chigger species richness. The bacterial microbiome of chiggers was highly diverse, with Sphingobium, Mycobacterium, Neisseriaceae and various Bacillales representing the most abundant taxa. Only Leptotrombidium deliense was found to be infected with Orientia. β-diversity, but not α-diversity, was significantly different between chigger species and geographic regions, although not between habitat types. This first field survey of the chigger microbiome provides a framework for future studies on interactions between pathogens and other symbionts in these understudied vectors.

scholarly journals Ecological and microbiological diversity of chigger mites, including vectors of scrub typhus, on small mammals across stratified habitats in Thailand

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Kittipong Chaisiri ◽  
A. Christina Gill ◽  
Alexandr A. Stekolnikov ◽  
Soawapak Hinjoy ◽  
John W. McGarry ◽  
...  
Keyword(s):  
Species Richness ◽  
Scrub Typhus ◽  
Bacterial Pathogen ◽  
Febrile Illness ◽  
Asia Pacific ◽  
Habitat Types ◽  
Widespread Species ◽  
Human Land Use ◽  
Β Diversity ◽  
Α Diversity

Abstract Background Scrub typhus, caused by a bacterial pathogen (Orientia spp.), is a potentially life-threatening febrile illness widely distributed in the Asia-Pacific region and is emerging elsewhere. The infection is transmitted by the larval stage of trombiculid mites (“chiggers”) that often exhibit low host specificity. Here, we present an analysis of chigger ecology for 38 species sampled from 11 provinces of Thailand and microbiomes for eight widespread species. Results In total, > 16,000 individual chiggers were collected from 1574 small mammal specimens belonging to 18 species across four horizontally-stratified habitat types. Chigger species richness was positively associated with higher latitudes, dry seasonal conditions, and host maturity; but negatively associated with increased human land use. Human scrub typhus incidence was found to be positively correlated with chigger species richness. The bacterial microbiome of chiggers was highly diverse, with Sphingobium, Mycobacterium, Neisseriaceae and various Bacillales representing the most abundant taxa. Only Leptotrombidium deliense was found to be infected with Orientia and another potential pathogen, Borrelia spp., was frequently detected in pools of this species. β-diversity, but not α-diversity, was significantly different between chigger species and geographic regions, although not between habitat types. Conclusion Our study identified several key environmental and host-derived correlates of chigger species richness across Thailand, which in turn impacted on human scrub typhus incidence. Moreover, this first extensive field survey of the chigger microbiome revealed species- and province-level variation in microbial β-diversity across the country, providing a framework for future studies on interactions between pathogens and other symbionts in these understudied vectors.

scholarly journals Clinical Features, Laboratory Findings and Complications of Scrub Typhus in South Indian Children

2017 ◽  
Vol 37 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Manjunath Vaddambal Gopalakrisna ◽  
Hedda Suryaprakash ◽  
G. Shankarappa Vijay Kumar ◽  
Kalenahalli Jagadish Kumar ◽  
Doreswamy Srinivasa Murthy
Keyword(s):  
Clinical Features ◽  
Scrub Typhus ◽  
Laboratory Data ◽  
Febrile Child ◽  
Standard Laboratory ◽  
Indian Children ◽  
Laboratory Findings ◽  
South Indian ◽  
Generalized Lymphadenopathy ◽  
Tropical Infections

Introduction: Scrub typhus clinical features are non-specific and resemble other tropical infections like malaria, dengue and typhoid fever. Therefore appropriate gold standard laboratory tests are necessary to confirm the diagnosis of scrub typhus. Aim of this study was to determine the incidence, clinical features, laboratory data and complications of scrub typhus in South Indian Children.Materials and Methods: Children with fever of more than seven days who were tested negative for common tropical infections were subjected to IgM-IFA for scrub typhus.Results: Out of 857 children, 74 were eligible for IFA test. Out of these, 27(3.1%) tested positive for scrub typhus. Clinical features included hepatomegaly (96.3%), generalized lymphadenopathy (81.5%), splenomegaly (81.5%), hypotension (59.3%), rash (14.8%), eschar (7.4%), thrombocytopenia (66.7%), elevation of SGOT (85.2%) and SGPT (81.5%). Complications include hepatitis (14.8%), pneumonia (14.8%), myocarditis (14.8%) meningoencephalitis (3.7%) and MODS (3.7%).Conclusion: Scrub typhus should be considered in the differential diagnosis of a febrile child having hepatosplenomegaly, lymphadenopathy, liver dysfunction and thrombocytopenia.  

Sign in / Sign up

Export Citation Format

Share Document