A retrospective observational study on Scrub typhus paediatric population in Kauvery Hospitals, Trichy

Abstract

Scrub typhus, an acute infectious disease caused by Orientia tsutsugamushi, is transmitted to humans through the bite of infected larval mites (chiggers) prevalent in rural and forested areas of Southeast Asia, the Indian subcontinent, northern Australia, and the western Pacific Islands. The disease is characterized by the formation of an eschar at the site of the mite bite, which appears as a shallow ulcer resembling a cigarette burn with undermined edges. Eschars are commonly found in hidden body areas and can be observed in 11-92% of cases. Other cutaneous manifestations include maculopapular rash in one-third of patients. The pathogenesis involves small vessel vasculitis affecting multiple organs, leading to complications such as pneumonia, meningoencephalitis, myocarditis, and acute respiratory distress syndrome if left untreated. Diagnosis is confirmed through serological tests like IgM capture ELISA, while treatment with azithromycin or doxycycline typically results in rapid clinical improvement. Scrub typhus should be differentiated from other tropical infections such as dengue fever, leptospirosis, typhoid fever, and malaria.