scholarly journals SCRUB TYPHUS IN CHILDREN: CLINICAL PROFILE AND COMPLICATIONS AT A TERTIARY CARE TEACHING HOSPITAL IN UTTARAKHAND

2017 ◽  
Vol 04 (02) ◽  
pp. 188-192 ◽  
Author(s):  
Shruti Kumar ◽  
Mritunjay Kumar ◽  
Bindu Aggarwal ◽  
Rashmi Kumari
Author(s):  
Sanjay Kumar Paliwal ◽  
Syed Javed ◽  
Arth Shah

Background: Snakebite - a global public health problem can be a traumatic experience for patients. They may develop local pain and swelling at the site with or without systemic involvement (haematological and neurological) and at times complications depending upon nature of snake. The present study was planned to determine the epidemiological and clinical profile of snakebite patients at a tertiary care teaching hospital of southern Rajasthan, India.Methods: This retrospective observational study was carried out at a tertiary care teaching hospital only after approval from institutional ethics committee. The data of patients aged between 18-80 years of either gender that had presented with a history of snakebite and admitted to the intensive care unit (ICU) in past 3 years were included. Data related to epidemiological, clinical and investigational parameters was collected and analysed. Data was presented as number (percentage) or mean ± standard deviation.Results: Total 80 patients were analyzed. Male:female ratio was 1.67:1 and mean age of study population was 33.91±14.34 years. Maximum 71 (89%) patients belonged to rural region. Only 16 (20%) patients complained of local pain. Bleeding was noted in 5 (6.25%) patients whereas 36 (45%) patients had ptosis. Prolonged coagulation markers were reported in 35 (44%) patients. Only 2 (2.5%) patients had acute kidney injury. Altered liver and renal function tests were noted in 71 (89%) and 63 (79%) patients respectively. Mechanical ventilation was required in 27 (34%) patients.Conclusions: Young adult males and rural population were prone to snakebites. Local and systemic manifestations were noted in relatively lesser patients compared to the published data. Only fewer patients in I.C.U. required mechanical ventilation.


Author(s):  
I. Sariga ◽  
S. S. Karthik ◽  
P. Vivian Joseph Ratnam

Background: Scrub typhus is a vector borne rickettsial disease commonly found in many parts of India. Scrub typhus can frequently cause complications like pneumonia, acute respiratory distress syndrome (ARDS) and has a mortality rate of 30 to 45% in untreated cases. Diagnosis of scrub typhus is difficult, with serum IgM capture ELISA being the most sensitive test. Present study objectives were to study the clinical and demographic profiles of scrub typhus cases in a tertiary care teaching hospital in the Union Territory of Puducherry, India.Methods: A descriptive study was carried out to analyze clinical and demographic profiles of patients who were positive for IgM antibodies against Orientia tsutsugamushi by scrub typhus IgM ELISA during a three year period (April 2015 to March 2018). Demographic details like age and sex of the patients, clinical signs, symptoms and complication if any were analyzed.Results: A total of 428 patients were found to have been diagnosed with scrub typhus during the study period. Among them, 46% were males and 54% were females. Among all the positive cases, 23.5% were paediatric cases, the second highest group was the 31 to 40 years age group (17.7%). Thirteen percent of positive cases were above 60 years of age. Fever was the most common symptom (92.9%) and eschar was found in 22.9% of patients. The most common complication found in the patients with scrub typhus was acute respiratory distress syndrome (15.9%). Other complications like hepatic dysfunction, pleural effusion and meningoencephalitis were noted.Conclusions: Adequate knowledge about scrub typhus helps in early diagnosis, which facilitates early appropriate antibiotic and supportive therapy, which helps in the recovery of the patient without acquiring complications.


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