Vomiting, myalgia, altered sensorium, seizures, and higher CRP levels predicted scrub typhus meningoencephalitis in 14.29% of children, requiring intensive care.
What are the clinical features and predictors of scrub typhus meningoencephalitis in children with undifferentiated fever or eschar?
Vomiting, myalgia, altered sensorium, seizures, and elevated CRP are significant predictors of scrub typhus meningoencephalitis in children.
A bstract Aims and Objectives: Scrub typhus is a reemerging disease that can cause severe complications like meningoencephalitis, especially in children. This study examines the clinical features and predictors of scrub typhus meningoencephalitis (SME). Materials and Methods: Conducted at a tertiary care hospital from October 2020 to September 2022, this study involved children aged 6 months to 18 years with undifferentiated fever or eschar. The diagnosis was confirmed using immunoglobulin M enzyme-linked immunosorbent assay, neurological assessments, and cerebrospinal fluid analysis. Results: Among 119 children (68 males), 17 (14.29%) had SME requiring intensive care for a longer duration. Significant predictors of SME included vomiting (58.8% vs. 17.6%), myalgia (35.3% vs. 10.8%), altered sensorium (29.4% vs. 2.9%), seizures (35.3% vs. 2%), and higher mean C-reactive protein levels (102.32 mg/L vs. 53.07 mg/L, P < 0.01). Conclusion: Early diagnosis of SME by monitoring key clinical and biochemical features and prompt treatment are crucial in reducing scrub typhus complications, especially in endemic regions.
Thomas et al. (2026) studied this question. Vomiting, myalgia, altered sensorium, seizures, and higher CRP levels predicted scrub typhus meningoencephalitis in 14.29% of children, requiring intensive care.