Journal of Rare Cardiovascular Diseases
ISSN: 2299-3711 (Print)
e-ISSN: 2300-5505 (Online)
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AN OBSERVATIONAL STUDY ON CLINICAL SPECTRUM AND OUTCOMES OF SCRUB TYPHUS IN PEDIATRIC AGE GROUP
DR SVS.SREEDHAR
DR.V. RAJESH KUMAR
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1
Associate professor, Department of Pediatrics, Apollo institute of medical science & research, Apollo Health City Campus, Film Nagar, Jubilee Hills, Hyderabad, Telangana, India
2
Professor, Department of Pediatrics, Apollo institute of medical science & research, Murukambattu, Chittoor, Andhra Pradesh, India.
Received: 2025-09-11
Revised: 2025-09-23
Accepted: 2025-10-15
Published: 2025-10-30
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Abstract
Background: Scrub typhus is increasingly recognized as a major cause of undifferentiated febrile illness in the pediatric population of South India. Due to its variable clinical presentation and the frequent absence of eschar, diagnosis is often delayed, particularly in resource-constrained hospitals. This study aimed to evaluate the clinical features, laboratory findings, and outcomes of children diagnosed with scrub typhus. Methods: This prospective observational study was conducted in the Department of Pediatrics, Apollo institute of Medical Science & Research, Apollo Health City Campus, Film Nagar, Jubilee Hills, Hyderabad, Telangana, India, from February 2024 to November 2024. A total of 84 children aged 2 months to 14 years, who tested positive for Orientia tsutsugamushi IgM via ELISA, were enrolled. Data were collected on presenting symptoms, physical findings, lab investigations, complications, and outcomes. Statistical analysis was used to assess predictors of severity. Results: All children presented with fever, while gastrointestinal symptoms such as vomiting (59.5%) and abdominal pain (41.7%) were frequently observed. Hepatomegaly (58.3%) and splenomegaly (35.7%) were common on examination. Eschar was detected in only 16.6% of children. Laboratory abnormalities included thrombocytopenia (69.0%), elevated liver transaminases (61.9%), and hyponatremia (52.3%). Complications included meningoencephalitis (11.9%), respiratory distress (10.7%), and acute kidney injury (4.7%). A total of 15 children (17.8%) required pediatric ICU care, and two children (2.3%) succumbed to multi-organ dysfunction. AST >180 IU/L and platelet counts <100×10⁹/L were significantly associated with severe outcomes (p<0.05). Conclusions: Scrub typhus in children often presents without eschar but with consistent systemic involvement. In endemic areas, the presence of hepatosplenomegaly, thrombocytopenia, and transaminitis in a febrile child should raise early suspicion. Timely recognition and empirical treatment can significantly reduce complications and mortality.
Keywords
Scrub typhus, Pediatric fever, Eschar, Hepatosplenomegaly, Thrombocytopenia, Transaminitis, South India, ICU outcomes, Rickettsial infections, Undifferentiated febrile illness.
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Keywords
Classification of Rare Cardiovascular Diseases
anticoagulation
atrial fibrillation
atrial septal defect
cardiomyopathy
computed tomography
congenital heart disease
echocardiography
electrocardiogram
electrocardiography
heart failure
implantable cardioverter‑defibrillator
magnetic resonance imaging
pregnancy
pulmonary arterial hypertension
pulmonary hypertension
rare cardiovascular disease
rare disease
right heart catheterization
right ventricular failure
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