“Clinico-Epidemiological Profile,Complications and Outcome of Scrub Typhus Among Hospitalized Paediatric Patients”:A Retrospective Study from a Tertiary Care Hospital in Nuh,Haryana.

Abstract

Objectives:-Clinico-Epidemiological Profile,Complications and Outcome of Scrub Typhus Among Hospitalized Paediatric Patients”:A Retrospective Study from a Tertiary Care Hospital in Nuh,Haryana.

Background:-Scrub typhus is an emerging and under diagnosed cause of acute febrile illness in children,particularly in rural and resource-limited settings.Caused by Orientia tsutsugamushi and transmitted by chigger mites,the disease often mimics other febrile illness and may lead to life-threatening complications if not identified early.The Nuh district (formerly Mewat) in Haryana is a predominantly rural and undeserved area with limited healthcare access,poor hygiene,and environmental conditions conducive to mite proliferation.These factors increase the risk and burden of scrub typhus in the pediatric population.However,there is a paucity of data on its clinical profile and outcomes in this region,underscoring the need for localized studies to guide early recognition and management.

Methods:-This retrospective study was conducted at a tertiary care hospital in Nuh(Mewat),Haryana.Medical records of 32 pediatric patients,aged 1 month to 14 years,admitted with a,confirmed diagnosis of scrub typhus over a defined period between September to December 2024 were reviewed.Diagnosis was established based on clinical features and positive serology (IgM ELISA for Orientia tsutsugamushi).Data regarding demographic details,clinical presentation,laboratory findings,complications,co-infections,treatment,hospital stay, and outcomes were collected in a predesigned proforma and entered in Microsoft excel master chart and analyzed using descriptive statistics.

Results:- Total 32 children included,19 were males and 13 were females.The majority (50%) were aged 1-5 years.Most cases occurred between September and December, following the post-monsoon season and coincide peak growth of vegetations and mite population.The majority of 27 (84.4%) cases were from Nuh district of Haryana while other 5 (15.6%) cases from neighbouring district of Nuh in which 3 (9.4%) cases from Alwar (Rajasthan) and 2 (6.3%) cases from Bharatpur (Rajasthan).Fever was present in all patients(100%),followed by respiratory distress (44%),altered sensorium (40%),seizures (40%),vomiting (38%),rash 10 (31%).Eschar was noted in 12.5% of cases.Anemia (Hb<11 g/dl) was seen in all patients,and thrombocytopenia (<100,000/mm³) in 43.7%.Common biochemical abnormalities included hypoalbuminemia (75%),elevated AST (37.5%),and raised alkaline phosphatase (50%).Coinfections were seen in 13 children,most commonly with enteric fever (5 cases) and dengue (4 cases).Major complications included hepatitis 15(47%),encephalopathy (41%),meningoencephalitis (28%),pneumonitis (34%),multiple organ dysfunction syndrome 6(19%).The duration of hospital stay ranged from 4 to 15 days.Overall,28 patients (87.5%) recovered,while 4 (12.5%) succumbed to the illness due to late presentation and multi-organ dysfunction.

Conclusion:-Scrub typhus is a under recognized cause of pediatric illness in endemic regions like Nuh(Mewat),Haryana,with peak incidence post-monsoon.Given its potential for severe complications,early clinical suspicion,timely diagnosis, and prompt treatment are essential.Public health efforts focusing on awareness,early diagnosis and preventive strategies are needed to reduce morbidity and mortality in such high-risk areas.

Keywords:- IgM ELISA ,Eschar ,Rash,Complications,Pneumonia,Hepatitis,Scrub Typhus