Objectives:

To determine the proportion of rickettsial infections among the children admitted with acute febrile illness. Design: Prospective and descriptive study. Setting: Child health department of Christian Medical Collage, a tertiary care hospital. Subjects: 180 children up to the age of 14 years with fever of 5 to 30 days duration. Methods: Those children who did not have specific diagnosis after routine work up for fever were screened for rickettsial infections. The clinical and laboratory profile of children who tested positive for rickettsial infections were recorded and frequency of various clinical manifestations were calculated. Results: Overall 43 (24%) among 180 children admitted with acute febrile illness in whom other common causes for fever were excluded, were clinically and serologically confirmed to have scrub typhus or other rickettsial infections. Scrub typhus formed the largest group (62.8%) followed by spotted fever (32.6%) and endemic typhus fever (4.7%). Liver involvement occurred in 58% with scrub typhus, where as rash was a predominant manifestation of spotted fever (86%). Twenty-two children given doxycycline became afebrile by 24 hours as well as two children who received chloramphenicol. One child with spotted fever given doxycycline did not respond but improved with chloramphenicol. Two children (4.7%) one each with spotted fever and scrub typhus died; both of them received chloramphenicol. Conclusions: These data suggest that rickettsial infections have re-emerged in India and contribute significantly to acute febrile illnesses in children. This emphasizes the need for effective control measures.

Keywords:

Children, India, Rickettsial, Scrub typhus, Spotted fever

Ooty Pedicon 2005 - Conference Abstracts. Pediatric Oncall [serial online] 2005 [cited 01 December 2005];2. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
typhus.asp