A study of clinical and laboratory profile of scrub typhus in children in a tertiary hospital in South India


  • Radha Kumar Department of Pediatrics, Saveetha Medical College, Chennai, Tamilnadu, India
  • Purusothaman Srinivasan Department of Pediatrics, Saveetha Medical College, Chennai, Tamilnadu, India




Eschar, Outcome, Scrub typhus


Background: Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi. The present study was conducted to study the clinical features, laboratory profile, complications and response to therapy among children suffering from scrub typhus in a tertiary health care institution of Tamil Nadu, India.

Methods: The study was conducted at Saveetha Medical College Hospital, Tamil Nadu, India. Duration of the study was from August to December, 2015 in the Department of Pediatrics. Children with clinically suspected Scrub typhus were subjected to detailed clinical examination and investigation. Diagnosis of scrub typhus was confirmed by IgM ELISA.

Results: 34 patients were diagnosed as suffering from scrub typhus. Common symptoms noted were fever, headache, cough and cold, chills, rigor, myalgia and vomiting. The common complications noted were thrombocytopenia in 16 children (47%) and features of meningoencephalitis and hepatitis were present in 2 children (5.8%). Eschar was identified in 24 (70.5%) patients. Mixed infection was seen in 4 (11.7%) children who had concurrent culture positive Urinary Tract Infection.   

Conclusions: Scrub typhus is an acute febrile illness which requires high index of suspicion for early diagnosis, monitoring of the clinical and laboratory parameters and prompt treatment which may help in complete cure without further complications and morbidity.  


Scrub typhus. Available at www.apiindia.org /medicine_update_2013/chap06.pdf. Accessed on 12 July 2016.

Sankhyan N, Saptharishi LG, Sasidharan K, Kanga A, Singhi SC. Clinical profile of scrub typhus in children and its association with hemophagocytic lymphohistiocytosis. Indian Pediatr. 2014;15:651-3.

Varghese GM, Trowbridge P, Janardhanan J, Thomas K, Peter JV, Mathews P, Abraham OC, Kavitha ML. Clinical profile and improving mortality trend of scrub typhus in South India. Int J Infect Dis. 2014;23:39-43.

Varghese GM, Raj D, Francis MR. Epidemiology and risk factors of scrub typhus in south India. Indian J Med Res. 2016;144:76-81.

Gupta VK, Agrawal P, Gupta RK, Sharma RB, Bhatnagar JP. Clinical profile of scrub typhus in relation with malaria and dengue seasonal outbreak from semi desert area of Rajasthan. India Int J Contemp Pediatr. 2016;3(3):943-8.

Palanivel S, Nedunchelian K, Poovazhagi V, Raghunadan R, Ramachandran P. Clinical profile of scrub typhus in children. Indian J Pediatr. 2012;79(11):1459-62.

Bhat NK, Dhar M, Mittal G, Shirazi N, Rawat A, Kalra BP. Scrub typhus in children at a tertiary hospital in North India: clinical profile and complications. Iran J Pediatr. 2014;24(4):387-92.

Singh SP, Singh R, Ahmad N. A study of complications of scrub typhus in a tertiary health care institute of Uttarakhand, India. Int J Res Med Sci. 2014;2(1):246-9.

Kim DM, Kim SW, Choi SH, Yun NR. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis. 2010;10:108.

Stephen S, Sangeetha B, Ambroise S, Sarangapani K, Gunasekaran K, Hanifah M, et al. Outbreak of scrub typhus in Puducherry and Tamil Nadu during cooler months. Indian J Med Res. 2015;142:591-7.

Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E. Serological evidence for widespread distribution of spotted fevers and typhus fever in Tamil Nadu. Indian J Med Res. 2007;126:128-30.

Chogle AR. Diagnosis and treatment of scrub typhus - the Indian scenario. J Assoc Physicians India. 2010;58:11-2.

Watt G. Scrub typhus. In: Warrell DA, Cox TM, Firth JD, eds. Oxford, Textbook of Medicine. 5th ed. USA: Oxford University Press; 2010:919-24.

Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India. 2010;58:24-8.

Somasekar HR, Prabhakar DM, Sreeja P, Elizabeth M, Didier R, Jean MR. Magnitude and features of scrub typhus and spotted fever in children in India. J Trop Pediatr. 2006;52:22.

Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in the Himalayan region of India. Japan Infect Dis. 2005;58:208-10.






Original Research Articles