Panda Subhasmita, Panda Kalpana, Swain Subrat Kumar, Gupta Medha, Sarangi Rachita
Department of Pediatrics, IMS and SUM Hospital, Siksha 'O ' Anusandhan (deemed to be) University, Bhubaneswar, Odisha, India.
Medical Research Laboratory, IMS and SUM Hospital, Siksha 'O ' Anusandhan (deemed to be) University, Bhubaneswar, Odisha, India.
J Vector Borne Dis. 2025 Apr 1;62(2):165-171. doi: 10.4103/JVBD.JVBD_56_24. Epub 2024 Oct 5.
Scrub typhus is an acute febrile zoonotic disease caused by the obligate intracellular gram-negative bacteria Orientia tsutsugamushi. Growing data over the last few years from the Indian subcontinent suggest that it is one of the most widespread but under-reported diseases. This study aimed to document the clinical and paraclinical profiles and evaluate complications of scrub typhus in severe and non-severe pediatric age groups.
A prospective observational study was conducted in pediatric patients. Frequency, mean, percentage and standard deviation were included in the descriptive statistical analysis calculations. Multivariate analysis was conducted to predict the severity factor.
A total of 189 patients met the eligibility criteria and were included in the final analysis. The mean and standard deviation (mean ± SD) age of the cohort was 5.54 ± 3.9 years, with a male predominance of 68.2%. The mean ± SD duration of fever was 6.64 ± 1.43 days. Patients with severe scrub typhus experienced complications including hepatic involvement (42, 64.6%), respiratory distress (23, 46.1%), neurological involvement (14, 24.6%), acute kidney injury (10, 15.4%), myocarditis (9, 13.8%), and (16, 24.6%) have multi-organ dysfunction. Patients with raised transaminases (> 180 IU/L) have a 3.7 to 4.1 times greater chance of developing severity. Thrombocytopenia is found to be another independent predictor of severe scrub typhus.
Clinical signs of hepatomegaly, skin rash, and lymphadenopathy were significant predictors of severity. Delay in treatment is a key contributor to the severity of pediatric scrub typhus.
恙虫病是一种由专性细胞内革兰氏阴性菌恙虫病东方体引起的急性发热性人畜共患病。过去几年来自印度次大陆的越来越多的数据表明，它是最广泛但报告不足的疾病之一。本研究旨在记录重症和非重症儿童年龄组恙虫病的临床和辅助检查特征，并评估其并发症。
对儿科患者进行了一项前瞻性观察研究。描述性统计分析计算中包括频率、均值、百分比和标准差。进行多变量分析以预测严重程度因素。
共有189例患者符合纳入标准并纳入最终分析。该队列的平均年龄和标准差（均值±标准差）为5.54±3.9岁，男性占68.2%。发热的平均±标准差持续时间为6.64±1.43天。重症恙虫病患者出现的并发症包括肝脏受累（42例，64.6%）、呼吸窘迫（23例，46.1%）、神经系统受累（14例，24.6%）、急性肾损伤（10例，15.4%）、心肌炎（9例，13.8%），以及16例（24.6%）有多器官功能障碍。转氨酶升高（>180 IU/L）的患者发生重症的几率高3.7至4.1倍。血小板减少症被发现是重症恙虫病的另一个独立预测因素。
肝肿大、皮疹和淋巴结病的临床体征是严重程度的重要预测指标。治疗延迟是儿童恙虫病严重程度的关键因素。
