Distribution of Eschar in Pediatric Scrub Typhus

Rose, Winsley; Rajan, Roshni Julia; Punnen, Anu; Ghosh, Urmi

doi:10.1093/tropej/fmw027

Cited by 33 publications

(25 citation statements)

References 12 publications

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“…We had renal involvement in 20% patients which was comparable to Rakholia et al [16]. In this study, eschar was present more in males (27.5%) as compared to females (7.5%) which was similar to Rose et al [18] who also had male preponderance. Mean age of children with eschar was 9.5 year and without eschar was 7.5 year.…”

Section: Original Research Articlesupporting

confidence: 89%

“…Incontrast to our observations, Rose et al [18] found significant association between the presence of an eschar and breathing difficulty, ARDS and thrombocytopenia, whereas absence of eschar was associated with meningitis. As far as outcome and mortality were concerned, just like Rakholia et al [16], we reported a favorable outcome and there was no mortality and morbidity which could be due to timely diagnosis with good supportive care.…”

Section: Original Research Articlesupporting

confidence: 81%

“…Mean age of children with eschar was 9.5 year and without eschar was 7.5 year. Rose et al [18] had mean age of 5 year and 7 year respectively. In our study, there was strong associationbetween the presence of an eschar and abdominal pain, facial edema, meningitis and ARDS where as absence of eschar was associated with headache.…”

Section: Original Research Articlementioning

confidence: 98%

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A study on clinico- laboratory parameters of children with scrub typhus in Garhwal region of Himalayan belt

Rathore¹,

Imran²,

Pathania

et al. 2019

Int J Pediatr Res

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Background:As there is paucity of data on Scrub typhus from Garhwal belt. So, to bridge this gap we conducted this study and tried to bring awareness about Scrub typhus. Methods: This is a descriptive study of 40 patients who were ELISA positive for Scrub typhus. A detailed history, demographic details, clinical features, complications, routine laboratory parameters and their relation with and without eschar was noted. Results: On analysis of demographic details, majority of scrub typhus patients belonged to Hilly district, Rudraprayag of Garhwal region. Common signs included fever (100%), lymphadenopathy and splenomegaly (70%), hepatomegaly (55%), rash (37%), eschar (35%), meningitis (20%), hepatitis and epistaxis (5%), pleural effusion, sub-conjunctival hemorrhage and ARDS (2.5%). Presence of eschar was strongly associated with abdominal pain, facial edema, meningitis and ARDS.Conclusion: Early diagnosis with high index of suspicion and timely treatment in children from hilly area with acute febrile illness decreases the mortality and leads to better prognosis.

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Section: Original Research Articlesupporting

confidence: 89%

Section: Original Research Articlesupporting

confidence: 81%

Section: Original Research Articlementioning

confidence: 98%

See 1 more Smart Citation

A study on clinico- laboratory parameters of children with scrub typhus in Garhwal region of Himalayan belt

Rathore¹,

Imran²,

Pathania

et al. 2019

Int J Pediatr Res

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“…Rose W et al, found 40.8% of their children having the characteristic eschar at the presentation but most studies project a lesser percentage. 9 Babu et al, in their prospective study found only 34.6% of serologically confirmed scrub typhus to have eschar. 10 Absence of eschar could be secondary to previous exposure to ricketssial antigen and variation in cutaneous immune response and that could be possible reason for absence of eschar in majority of our study children.…”

Section: Discussionmentioning

confidence: 95%

Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children

Elangovan

Rajesh

2019

Int J Contemp Pediatr

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Background: Objective of study was to compare the clinical features and laboratory parameters at admission and differentiate severe dengue from scrub typhus in children.Methods: Retrospective analysis of case records and comparison of clinical and laboratory parameters at admission of all children with a diagnosis of severe dengue and scrub typhus was done.Results: A total of 72 children were included (severe dengue =40; scrub typhus =32) during the study period. The mean (SD) age of children with severe dengue and scrub typhus was 7.9(3.8) and 11.8(5.8) years, respectively. Majority of children with severe dengue presented with hypotension, 21(52.5%) vs 3(9.4%) in scrub typhus. Children with severe dengue had a relatively low ANC (2.6±1.97x103/mm3 vs 3.9±2.06x103/mm3), low platelet count (50.23±35.55x103/mm3 vs 140±95.0x103/mm3) and low mean ESR at 1hour (8.1±6.82mm vs 33.88±13.79mm) than scrub typhus.Conclusions: Compared to scrub typhus, severe dengue was significantly associated with hypotension, lower ANC, ESR and platelets.

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“…Although eschar being the pathognomonic features, was identified only in a small number of cases which challenges clinical diagnosis. 16,17,9,18,19,20,21 Primary risk factor for increased morbidity and mortality was delayed diagnosis. 22 In the present study, 58% of children are school going and hence exposed to the presence of infected chigger in the shrubs.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profile of pediatric scrub typhus in a tertiary care teaching hospital in Southern India

Lakshmanan

Sagayaraj

Sujatha

et al. 2018

Int J Contemp Pediatr

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Background: Scrub typhus is a common aetiology for an acute undifferentiated fever among children. Early recognition and prompt management help to reduce morbidity and mortality.Methods: All children who visited our pediatric out-patient department between January 2016 and February 2018, admitted with clinical suspicion of scrub typhus and having positive serum IgM by ELISA were included in the study.Results: A total of 83 cases were enrolled during the study period. Of these 55 were boys and 28 girls. The average age of presentation was seven years, and the youngest was just five months old. Majority of these patients were from rural areas (86%). Roughly, two-thirds (77%) of the study group practiced open defecation. A maximum number of cases (65;78.3%) were reported during monsoon season (between September and January).Prolonged fever (100%), gastrointestinal symptoms (76%) such as vomiting, diarrhoea and abdominal pain, lymphadenopathy (96%) and hepatosplenomegaly (61%) were common signs and symptoms of pediatric scrub typhus. Only six patients had severe illnesses. The diagnosis was based on the positive serum IgM for scrub typhus. All the patients were IgM positive. Out of these 83 patients, eschar was seen in 50 (60%) patients. Weil Felix test was positive in 15 cases out of 33 tested cases. Six children had co-infection with 2 cases of malaria and four dengue fever cases.Conclusions: Scrub typhus is one of the common causes for acute undifferentiated fever among children. A high index of clinical suspicion and a lookout for an eschar shall facilitate an early diagnosis of scrub typhus.

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Distribution of Eschar in Pediatric Scrub Typhus

Abstract: Children should be carefully examined for the presence of eschar especially in the skin folds of the genitalia, axillae and groin to make an early diagnosis of scrub typhus.

Cited by 33 publications

References 12 publications

A study on clinico- laboratory parameters of children with scrub typhus in Garhwal region of Himalayan belt

A study on clinico- laboratory parameters of children with scrub typhus in Garhwal region of Himalayan belt

Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children

Clinical and laboratory profile of pediatric scrub typhus in a tertiary care teaching hospital in Southern India

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