Key result
Abnormal chest radiography in pediatric scrub typhus is linked to a longer time to defervescence.
Why the study?
Scrub typhus emerged in northern China in 1986, and the epidemiologic, clinical, and laboratory features of pediatric scrub typhus in this new endemic area were undocumented.
Observational (n=70)
No
p-value: p=0.011
Pediatric scrub typhus in northern China presents with high rates of headache, rash, and eschar, but lacks severe neurologic involvement or thrombocytopenia, and responds well to chloramphenicol.
Alerts clinicians to pediatric scrub typhus in emerging northern China areas; leaves open optimal diagnostics and management strategies.
BACKGROUND: Scrub typhus emerged in northern China in 1986. Our objective was to document epidemiologic, clinical and laboratory features of pediatric scrub typhus in this new endemic area. METHODS: The pediatric patients diagnosed with scrub typhus during the 12-year period from 1995 through 2006 in Feixian County, Shandong province were enrolled in the study. The cases were diagnosed based on either specific antibody detection using the indirect immunofluorescent assay or detection of partial Orientia tsutsugamushi gene by polymerase chain reaction. RESULTS: Seventy pediatric scrub typhus cases were included in the study. The cases occurred from September through November. The common clinical manifestations included headache (100%), skin rash (91%), eschar (84%), lymphadenopathy (61%), and gastrointestinal signs (56%). None of the patients had neurologic involvement or thrombocytopenia. All children responded well to treatment with chloramphenicol. The patients who presented with abnormal chest radiography took significantly longer time to defervescence (Z[r] = 2.528, P = 0.011). Three strains of O. tsutsugamushi were isolated and all were identified as Kawasaki type. CONCLUSIONS: The manifestations of pediatric scrub typhus cases in the novel endemic region of northern China may be less severe than in other regions. Careful examination of skin eschars is helpful for the clinical diagnosis.
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Liu et al. (2009) conducted an observational in Pediatric scrub typhus (n=70). Pediatric scrub typhus was evaluated on Clinical manifestations and time to defervescence (p=0.011). Pediatric scrub typhus in northern China commonly presented with headache (100%), skin rash (91%), and eschar (84%), with abnormal chest radiography associated with a longer time to defervescence (P=0.011).