CNS Manifestations in Orientia tsutsugamushi Disease (Scrub Typhus) in North India

Indian Journal of Pediatrics
Ashwani Kumar SoodHemant Gupta

Abstract

To present the clinical, lab profile and outcome of a series of six children who had features of meningoencephalitis (median age of 10.5 y) diagnosed as confirmed scrub typhus (ST) by using a lgM ELISA commercial kit (InBiOS International Inc. USA). This was a prospective observational study conducted at a tertiary care hospital, over a period of 7 mo through April 2014. All the patients with undifferentiated febrile illness (aged 1-18 y) with fever of 5-21 d duration were evaluated. After thorough physical examination they were subjected to blood investigations such as complete blood count (CBC), blood culture, hepatic and kidney function tests, serum electrolytes, cerebrospinal fluid (CSF) analysis and IgM ELISA for scrub typhus, coagulogram and chest radiograph, wherever indicated. During this period, of the total 81 confirmed cases based on a positive scrub IgM ELISA and/or eschar, 6 (7.4 %), had neurological involvement in the form of presence of neck stiffness, altered sensorium and/or seizures and the CSF findings were suggestive of meningoencephalitis and all had evidence of multiple organ dysfunction syndrome (MODS) needing intensive care. The CECT could be performed in four patients only showing evidence of effacement...Continue Reading

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Citations

Oct 8, 2016·Infectious Diseases of Poverty·Sunuraj SivarajanRittwick Barman
Dec 23, 2017·Journal of Tropical Pediatrics·Narayanasamy Dinesh KumarDevi Kittu
Mar 13, 2019·The American Journal of Tropical Medicine and Hygiene·Meghna PhanichkrivalkosilStuart D Blacksell
May 11, 2018·The Pediatric Infectious Disease Journal·Mahima MittalMohan D Gupte
Apr 28, 2017·Transactions of the Royal Society of Tropical Medicine and Hygiene·Senaka RajapakseSumadhya Deepika Fernando
Apr 1, 2017·Indian Pediatrics·Narendra RathiUNKNOWN For Indian Academy of Pediatrics Guidelines on Rickettsial Diseases in Children Committee

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