Naveen Sankhyan1, L G Saptharishi, Kandasamy Sasidaran, Anil Kanga, Sunit C Singhi. 1. Department of Pediatrics, PGIMER, Chandigarh; and *Department of Microbiology, Indira Gandhi Medical College, Shimla, India. Correspondence to: Prof. Sunit C Singhi, Professor and Head, Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India. sunit.singhi@gmail.com.
Abstract
OBJECTIVE: To study the clinical profile of children with scrub typhus and its association with hemophagocytic lymphohistiocytosis. METHODS: Children presenting with unexplained fever and multi-systemic involvement between May to December 2011 were tested for scrub typhus using IgM ELISA kits. Occurrence of Hemophagocytic lymphohistiocytosis in IgM positive cases of scrub typhus was studied. RESULTS: Of the 35 children with unexplained fever and multi-systemic involvement, 15 children (9 boys) tested positive for scrub typhus. Thrombocytopenia, hypoalbuminemia and raised hepatic transaminases were observed in all children. Out of seven children evaluated for hemophagocytic lymphohistiocytosis. 3 met the criteria for hemophagocytosis. Two children (one with hemophagocytic lymphohistiocytosis) died. CONCLUSIONS: Scrub typhus is a common cause of unexplained fever in children in northern India. Hemophagocytic lymphohistiocytosis can occasionally complicate scrub typhus in children.
OBJECTIVE: To study the clinical profile of children with scrub typhus and its association with hemophagocytic lymphohistiocytosis. METHODS:Children presenting with unexplained fever and multi-systemic involvement between May to December 2011 were tested for scrub typhus using IgM ELISA kits. Occurrence of Hemophagocytic lymphohistiocytosis in IgM positive cases of scrub typhus was studied. RESULTS: Of the 35 children with unexplained fever and multi-systemic involvement, 15 children (9 boys) tested positive for scrub typhus. Thrombocytopenia, hypoalbuminemia and raised hepatic transaminases were observed in all children. Out of seven children evaluated for hemophagocytic lymphohistiocytosis. 3 met the criteria for hemophagocytosis. Two children (one with hemophagocytic lymphohistiocytosis) died. CONCLUSIONS: Scrub typhus is a common cause of unexplained fever in children in northern India. Hemophagocytic lymphohistiocytosis can occasionally complicate scrub typhus in children.
Authors: Kartika Saraswati; Brittany J Maguire; Alistair R D McLean; Sauman Singh-Phulgenda; Roland C Ngu; Paul N Newton; Nicholas P J Day; Philippe J Guérin Journal: PLoS Negl Trop Dis Date: 2021-10-14
Authors: Alison Luce-Fedrow; Marcie L Lehman; Daryl J Kelly; Kristin Mullins; Alice N Maina; Richard L Stewart; Hong Ge; Heidi St John; Ju Jiang; Allen L Richards Journal: Trop Med Infect Dis Date: 2018-01-17