scholarly journals An analysis of clinical presentation and laboratory profile of scrub typhus among pediatric population in a semi urban centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1160
Author(s):  
Sathyamoorthy M. ◽  
Subash S. ◽  
Karthikeyan P. ◽  
Prasanna Raju
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Study Group ◽  
Urban Centre ◽  
College Hospital ◽  
Laboratory Profile

Background: Scrub typhus is a re-emerging acute infectious disease caused by Orientia (Rickettsia) tsutsugamushi, in India and globally. Scrub typhus goes undiagnosed at early stages of the illness because many factors like of low index of suspicion, nonspecific signs and symptoms. This study was done to analyse the various clinical demographic factors and their significance in making the clinical diagnosis of scrub typhus and also the analysis of other non-specific laboratory parameters present in the serologically confirmed cases of scrub typhus. The objective of this study was to study the clinical presentation and laboratory profile of scrub typhus in pediatric patients admitted in a tertiary care hospital.Methods: It was prospective and descriptive study conducted in the pediatric ward of a Medical College Hospital. The study population consisted of 50 children aged 5-15 years having fever of more than 5 days duration. Children with persistent fever with known focus and etiology were excluded from the study.Results: Among the study group of 50 children, majority were between 5 and 15 years age group. Male children constituted 66% (33 out of 50). Out of 50 children, 94% (47 children) had Eschar.  82% of children did not have any history of tick exposure. Less than 25% of children had Vomiting similar to conjunctival congestion. 94% children had lymphadenopathy and 98% children had mild anemia. 54% children had maculopapular rash and 20% had jaundice. 62% children had hepatomegaly and 96% had splenomegaly. Pedal edema was seen in 22% of cases and anasarca in 2% of cases 76% of children had normal WBC counts, 24% had leucocytosis. Platelet counts of 38,000 to 2,87,000 was noted in the study group and 26% of patients had thrombocytopenia. 98% children had hemoglobin less than 10 gms%. C reactive protein was positive in 96% of cases. Hypoalbuminemia was noted in 48% of children. 60% children were positive for urine albumin. Conclusions: Scrub typhus should be considered in early part of the illness and patient has to be examined for the presence of Eschar. A clinical diagnosis can be made based on the associated rash, splenomegaly, lymphadenopathy etc. and specific treatment with antimicrobials can be initiated for scrub typhus. 

scholarly journals Clinicoepidemiological Profile of Childhood Poisoning in the Pediatric Unit of a Tertiary Care Hospital in North India

2019 ◽  
pp. 1-8
Author(s):  
Rahid Rasool Malla ◽  
Khalid Kawoosa ◽  
Meryem Juwhyreeyeh ◽  
Riyaz Ahmed Malik ◽  
Asif Ahmed ◽  
...  
Keyword(s):  
Parental Education ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Age Groups ◽  
Gastric Lavage ◽  
North India ◽  
Care Hospital ◽  
Age Group ◽  
College Hospital ◽  
Childhood Poisoning

Background: This study was conducted to find out the pattern of poisoning cases among the pediatric population in Srinagar and its Northwestern suburbs and compare it with what occurs elsewhere in India. Thereby we aimed to provide practical knowledge in dealing with these pediatric patients. Methods: The hospital records of children between the ages of 0-19 years admitted to the pediatric emergency ward of SKIMS Medical College Hospital Srinagar with poisoning from July 2016 to June 2018 were evaluated. Results: A total of 154 cases of poisoning were admitted in the study period, of which 89(57%) were males and 69(43%) were females. In the 0-12 year age group the poisonings were mostly in boys (68.26%) and were accidental whereas in the 13-19 year age group poisonings were mostly in girls (64%) and due to suicidal attempts. Organophoshorus poisoning was the most commonly ingested poison across all age groups (44.8%) followed by rodenticides (16.23%), kerosene (13.63%) and medications (11.68%). Interventions mostly commonly done were gastric lavage, induced vomiting. Mortaliy was seen in 2 cases over 2 years (1.29%). Conclusion: Knowledge on epidemiological and clinical features of poisoning in children according to age groups, establishing safety standards for sale and storage of harmful chemicals, and parental education can help to decrease the burden of childhood poisoning.

scholarly journals Clinical profile and outcome of patients admitted to pediatric intensive care unit in a tertiary care teaching hospital of Puducherry, India

2020 ◽  
Vol 7 (6) ◽  
pp. 1280
Author(s):  
Maheswari K. ◽  
Neha Sharma
Keyword(s):  
Electric Shock ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Age Distribution ◽  
Acute Otitis Media ◽  
Clinical Profile ◽  
Research Centre ◽  
College Hospital ◽  
Care Teaching ◽  
Common Diagnosis

Background: This study was undertaken to know about the clinical profile and outcome of patients admitted in paediatric ICU in a tertiary care teaching hospital.Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to paediatric ICU of Sri Venkateshwara Medical College Hospital and Research Centre Puducherry from Jan 2019 - Dec 2019 (12 months).Results: As about 424 patients were admitted paediatric ICU. 79 patients were excluded from the study. Remaining 345 PICU patients were analysed. According to the age distribution of patients, it showed that < 1year were (25.2%), 1-5 years were (44.3%), > 5years of age were (30.4%). There was a female preponderance (58.8%), males were (41.1%). Patients from rural area were 243 (70.4%) and 102 (29.5%) from urban area. Clinical profile showed that pneumonia was the most common diagnosis (8.4%) for admission in PICU. This was followed by bronchiolitis (6.9%), enteric fever in (6.6%), febrile seizures (6.3%), poisoning (6.0%), renal problems (5.7%), occult bacteremia (5.5%), unknown bite (5.2%), acute severe asthma (4.9%), sepsis (4.6%), severe gastritis (4.3%), clinical dengue (3.7%), seizure disorder (3.4%), croup (3.1%), traumatic head injury (2.8%), wheeze associated LRI (2.6%), acute otitis media (2.3%), migraine (2.0%), meningitis (1.7%), CHD with complications (1.7%), severe anaemia with CCF (1.4%), acute urticarial (1.4%), foreign body (1.1%), electric shock (1.1%), scorpion sting (0.8%), viral hepatitis (0.8%), clinical malaria (0.8%), nephrotic syndrome with complications (0.5%), scrub typhus (0.2%) and (0.2%) was angioedema. The outcome noted was, (87.8%) were discharged, (10.7%) patients went against medical advice, (1.4%) patients were referred at parent’s request.Conclusions: Respiratory illness, infectious diseases, neurological problems and poisoning are the most common cause for PICU admissions. But seronegative dengue cases, electric shock, reemergence of scrub typhus, are being increasingly diagnosed. So, emphasis is therefore placed on high index of suspicion for this type of conditions. We also recommend better manpower and infrastructure to improve the outcome of patients admitted to PICU.

scholarly journals Clinical and Laboratory Profile and Therapeutic Response of Scrub Typhus in Children in a Tertiary Care Centre in Nepal

2020 ◽  
Vol 5 (1) ◽  
pp. 897-901
Author(s):  
Sumit Agrawal ◽  
Krishna Hari Subedi ◽  
Rajesh Kumar Shah ◽  
Santoshanand Jha ◽  
Sher Bahadur Pun
Keyword(s):  
Retrospective Study ◽  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Disease ◽  
Tertiary Care Centre ◽  
Institutional Review ◽  
Laboratory Profile ◽  
Loss Of Appetite

Introduction Scrub typhus is the most common ricketisial infection from the Indian subcontinent. It is caused by the organism Orienta tsutsugamushi inhabiting in trombiculid mites and transmitied to humans by the bite of these mites. The disease has a variety of clinical manifestations in children. As this is a common disease in our country so a retrospective study was conducted to study the clinical and laboratory profile and therapeutic outcomes of scrub typhus in children. Methodology A retrospective study was conducted at Sukraraj Tropical and Infectious disease Hospital, Teku, Kathmandu, Nepal after obtaining ethical clearance from Institutional Review Committee, and reviewing the medical records of serologically confirmed scrub typhus in children aged less than 14 years admitted to the hospital between March 2017 and February 2018. Relevant data were entered in excel spreadsheet and analyzed using SPSS 20. Result A total of 20 children were enrolled in the study. Of them 70% were female, with the mean age being 11.45 ± 3.1 years (range 3-14 years) and majority were from Dhading district (40%). All the children had fever; while there was cough, loss of appetite, rashes, headache, myalgia, arthralgia and hepatosplenomegaly in 45%, 90%, 20%, 55%, 35%, 35% and 30% of children respectively. There was thrombocytopenia in 50% of children; while hyponatremia, elevation of SGOT and SGPT was present in 30%, 70% and 55% of patients respectively. Azithromycin was used for treatment in 95% of children and all had defervescence of fever. Conclusion Scrub typhus should be suspected in children having prolonged fever with organomegaly, thrombocytopenia and elevated transaminases. Azithromycin can be used effectively in children diagnosed as scrub typhus.

scholarly journals Clinico-Laboratory Profile, Complications and Therapeutic Outcome of Scrub Typhus in Children

2020 ◽  
Vol 18 (2) ◽  
pp. 282-287
Author(s):  
Ram Hari Chapagain ◽  
Sumit Agrawal ◽  
Sunita Pokharel ◽  
Madhusudhan Kayastha ◽  
Susan Bhattrai ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Febrile Illness ◽  
Abdominal Distension ◽  
Therapeutic Outcome ◽  
Care Hospital ◽  
Middle Income ◽  
Increased Risk ◽  
Laboratory Profile

Background: Scrub typhus, an important cause of undifferentiated fever, is grossly neglected and often misdiagnosed in low and middle income countries like Nepal. The main aim of this study was to describe the clinico-laboratory profile, drug used in treatment, predictor of PICU admission and therapeutic outcome of serologically confirmed scrub typhus among Nepalese children.Methods: A prospective observational study was carried out in children aged up to 14 years with serologically (IgM ELISA) diagnosed Scrub typhus, admitted in a tertiary care hospital of central Nepal between Jan 2019 to Dec 2019.Results: All 100 children with scrub typhus presented with fever. Other symptoms and sign were cough (29%), abdominal distension (22%) hepatomegaly (45%), splenomegaly (28%), crepitation (10%) and eschar (6%). Similarly, thrombocytopenia (72%), and increased liver enzymes SGPT (51%) and SGOT (62%) were found. Co-infection with dengue (5%) brucella (5%) and UTI (5%) were seen. Thirty six percent has some form of complication. Fifty eight percent of children were treated with azithromycin and 25% treated with doxycycline. The mean length of hospital stay was 6.68 ±2.97 days with a mean duration of defervescence being 30.07 ± 26.65 hours. The increased risk of PICU admission was found in those children with crepitation in chest (OR: 15.17, 95% CI: 3.4-66.8) during presentation and those children not getting azithromycin as treatment (OR: 3.8, 95% CI: 1.2-11.7)Conclusions: Scrub typhus should be considered as a differential diagnosis in any community acquired acute undifferentiated febrile illness regardless of the presence of an eschar. Sepsis, meningitis and pneumonia are important complications. Child having crepitation on presentation has an increased chance admission in critical care unit. The child receiving azithromycin has less chance to land in PICU.Keywords: Clinico-laboratory profile; complications; fever; scrub typhus.

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