AN OBSERVATIONAL STUDY OF 14 NEONATES WITH SCRUB TYPHUS

Main Article Content

Dr. C. Mary Reena
Dr. J. Ashok Raja
Dr. Shetty Subhodh Sivarama
Dr. D. S. Jothi

Keywords

Neonatal scrub typhus, IgM ELISA, rickettsia, coagulopathy

Abstract

Scrub typhus is a rickettsial infection causing pneumonia, myocarditis, bone marrow suppression, Disseminated Intravascular Coagulation and multi-organ failure. Presentation in neonates is rare. We conducted this study on neonates diagnosed as scrub typhus, discuss their clinical presentation and review the literature. The neonates admitted in a tertiary care centre with clinical diagnosis of sepsis were enrolled for the study. Clinical presentation, epidemiology, risk factors, laboratory findings and treatment were recorded. Diagnosis was confirmed by IgM ELISA test and the clinical response to Doxycycline was noted. Anemia, thrombocytopenia and coagulopathy were seen in all neonates. Eschar was not noticed in these cases. Mortality was high (57.1%). Scrub typhus, a sepsis mimicker needs early evaluation and a trial of Doxycycline in suspected neonates my save lives. Polymerase Chain Reaction confirmation and epidemiological surveillance is necessary to standardize antibody kits and controlling endemic.

Abstract 117 | pdf Downloads 36

References

1. Wang CL, Yang KD, Cheng SN, Chu ML.Neonatal scrub typhus: A case report. Pediatrics. 1992; 89: 965-968.
2. Hornick RB. In: Bennett JC, Plum F.editors. Goldman: Cecil Textbook of medicine. 21st ed. Philadelphia, USA: WB Saunders Company. 2000; 1911-2.
3. Varghese GM, Trowbridge P, Janardhanan J, et al. Clinical profile and improving mortality trend of scrub typhus in South India. Int J Infect Dis. 2014;23:39–43.
4. Goldstein, B., Giroir, B., & Randolph, A. (2005). International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics*. Pediatric Critical Care Medicine, 6(1), 2–8.
5. Robert M, Kliegman B, Stanton S, Joseph St.Geme, Nina F Schor. Nelson Text book of Pediatrics. 20th ed. Philadelphia, USA: Elsevier. 2016; P: 1503.
6. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principle of Internal Medicine. 18th ed. USA: The McGraw-Hill Companies; 2012. pp. 1064 65.
7. Aarthi P, Bagyalakshmi R, Mohan KR et al. First case series of emerging Rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing.Indian J Med Microbiol.2013; 31: 343-348.
8. Paramanantham P, Sathyamoorthy DP, Sekar DP. Neonatal scrub typhus:Case report. World J Pharm Res. 2018;7:836 40.
9. Samad TEA, Kamalarathnam CN. Clinical Profile of Scrub Typhus in Newborns. Indian Pediatr. 2020 ;57(6):579.
10. Deglurkar, R., Murugesan, A. Plakkal, N. Neonatal Scrub Typhus: A Case Series. Indian J Pediatr (2023).
11. Bhat NK, Pandita N, Dhar M. Scrub Typhus Eschar. Indian Pediatr. 2020 Jan 15;57(1):93.
12. Rahi M, Gupte MD, Bhargava A, Varghese GM, Arora R. DHRICMR guidelines for diagnosis & management of rickettsial diseases in India. Indian J Med Res.2015;141:417–22.
13. Roopa KS, Karthika K, Sugumar M et al. Serodiagnosis of scrub typhus at a tertiary care hospital from southern India. J Clin Diagn Res. 2015;9:DC05–7.
14. Blacksell SD, Tanganuchitcharnchai A, Nawtaisong P, et al. Diagnostic accuracy of the in bios scrub typhus detect enzymelinked immunoassay for the detection of IgM antibodies in northern Thailand. Clin Vaccine Immunol. 2015;23:148–54.
15. Peter JV, Sudarsan TI, Prakash JAJ, Varghese GM. Severe scrub typhus infection: clinical features, diagnostic challenges and management.World J Crit Care Med. 2015;4:244–50.
16. Eberly MD, Eide MB, Thompson JL, Nylund CM. Azithromycin in early infancy and pyloric stenosis. Pediatrics. 2015 Mar;135(3):483-8.