clinical profile and predictors of outcome for pediatric scrub typhus at a tertiary care hospital

Background: scrub typhus is an important cause of acute undifferentiated fever. it is currently one of the most covert reemerging infections and the most common rickettsial infection caused by orientia tsutsugamushi. untreated cases can have mortality rates as high as 30-35%. objectives: this study was done to study demographical data, clinical profile, and predictors of outcome for scrub typhus in children who were admitted to our institution, a tertiary care hospital in south india. methods: in this retrospective study, children diagnosed with scrub typhus based on igm enzyme-linked immunosorbent assay (elisa), between january 2012 and june 2019 were included. detailed history, clinical examination findings, laboratory profile, complications, and outcome were analyzed. results: a total of 120 patients were identified, of whom 84 (42 males- and 42 females) cases satisfied the inclusion criteria and were analyzed. about 80 (95%) cases had a complete recovery, whereas 4 patients (5%) died of multiple complications. hypotension, hypoxia, altered sensorium, hypoalbuminemia, elevated liver enzymes, azotemia, and deranged coagulation on admission were considered as poor predictors of outcome for scrub typhus. conclusions: pediatric scrub typhus is a common infection and should be suspected in cases with fever for more than 5 days and non-specific signs and symptoms. early detection and timely management lead to a higher recovery rate. hypotension, hypoxia, azotemia, altered sensorium, and bleeding manifestations on admission were associated with unfavorable outcomes.