Behera Bijayini, Satapathy Amit Kumar, Ranjan Jai, Chandrasekar Shyam, Patel Subhakanta, Mishra Baijayantimala, Mahapatro Samarendra, Das Rashmi Ranjan
Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Neurosci Rural Pract. 2021 Sep 22;12(4):786-791. doi: 10.1055/s-0041-1734003. eCollection 2021 Oct.
The aim of this article was to study the spectrum of scrub typhus meningitis/meningoencephalitis (STM) cases in children. Children ≤14 years of age with acute undifferentiated febrile illness were included. Immunoglobulin M (IgM) enzyme-linked immunosorbent assay was done in blood and cerebrospinal fluid (CSF) of children with suspected STM. Demographic, clinical, and laboratory details were expressed as descriptive statistics. Factors associated with neurological involvement were identified on univariate analysis. A total of 76 children had ST during the study period (meningitis/meningoencephalitis = 8 [10.5%], of which 5 [62.5%] had detectable ST IgM antibodies in CSF). The included children were 4 to 12 years of age with boys > girls. Headache and vomiting were common in those with STM, whereas hyponatremia and thrombocytopenia were common in those without STM. All children with STM recovered with sequelae in one child (right lateral rectus palsy). There was no mortality. STM has an incidence of 10.5% in children with ST from Eastern India. Headache and vomiting were significant predictors of STM, whereas hyponatremia and thrombocytopenia were significant predictor of non-STM.
本文旨在研究儿童恙虫病性脑膜炎/脑膜脑炎(STM)病例的情况。纳入年龄≤14岁的急性未分化发热性疾病患儿。对疑似STM的患儿进行血液和脑脊液(CSF)的免疫球蛋白M(IgM)酶联免疫吸附测定。人口统计学、临床和实验室详细信息以描述性统计表示。通过单因素分析确定与神经受累相关的因素。在研究期间,共有76名儿童患有恙虫病(脑膜炎/脑膜脑炎=8例[10.5%],其中5例[62.5%]脑脊液中可检测到恙虫病IgM抗体)。纳入的儿童年龄为4至12岁,男孩多于女孩。STM患儿常见头痛和呕吐,而无STM的患儿常见低钠血症和血小板减少症。所有STM患儿均康复,1例有后遗症(右侧外直肌麻痹)。无死亡病例。在印度东部患有恙虫病的儿童中,STM的发病率为10.5%。头痛和呕吐是STM的重要预测因素,而低钠血症和血小板减少症是非STM的重要预测因素。