Original research article/Artykuł oryginalny Clinical profile of scrub typhus in children treated in a tertiary care hospital in eastern India Rachita Sarangi 1, *, Sarita Pradhan 2 , Nagen ch Debata 3 , Sitaram Mahapatra 4 1 Department of Paediatrics, IMS and SUM Hospital, Siksha O Anusandhan University, Odisha, India 2 Department of Pathology, IMS and SUM Hospital, Siksha O Anusandhan University, Odisha, India 3 Department of Microbiology, IMS and SUM Hospital, Siksha O Anusandhan University, Odisha, India 4 Department of Pathology, Government of Odisha, Bhubaneswar, Odisha, India Introduction Although mortality rate for malaria has decreased globally, non-malarial infections remain the major cause of mortality and morbidly in most part of south East Asia. Rickettsial diseases are among the most covert re-emerging infection on the present era. Overall Rickettsial infection is found to be the second most cause of non-malarial febrile illness in South East Asia after dengue [1]. Scrub typhus is p e d i a t r i a p o l s k a x x x ( 2 0 1 6 ) x x x – x x x a r t i c l e i n f o Article history: Received: 04.03.2016 Accepted: 13.04.2016 Available online: xxx Keywords:  Scrub typhus  Serosal effusion  Eschar  Rickettsia a b s t r a c t Background and objective: Odisha in the eastern region of India has been witnessing an increased incidence of pediatric scrub typhus. The present study was undertaken to study the clinical profile, laboratory parameters, complications and efficacy to therapy in scrub typhus. Design: Prospective observational study. Material and Methods: Total 71 children up to 14 years of age who had fever for more than 5 days without an identifiable cause were included in the study. All suspected cases were tested with Weil-Felix test (OX- K  1:80 positive) and IgM antibody (ELISA) against Orientia tsutsugamushi. All IgM positive cases were further studied for response to Azithromycin therapy. Results: Twenty six child- ren were diagnosed with scrub typhus between July 2015 and December 2015. The age of patients ranged from eleven months to twelve years. Majority of patients (69.2%) were from rural areas. The common symptoms were fever, headache, hepatomegaly, lymphadenopa- thy and serosal effusions. Eschar was seen only in 30.7% of cases. Leucocytosis was seen in 76.9% of cases and 61.5% of cases had anicteric hepatitis. Commonest complications seen were hepatitis (61.5%) and pneumonia (38.4%). All cases responded well to Azithromycin therapy. Conclusions: Our result showed that scrub typhus should be suspected in all cases of fever without an identifiable cause irrespective of age. Serosal effusions and anicteric hepatitis must raise the possibility of scrub typhus among clinicians. © 2016 Polish Pediatric Society. Published by Elsevier Sp. z o.o. All rights reserved. * Corresponding author at: Department of Paediatrics, IMS and Sum Hospital Bhubaneswar, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, Odisha, India. Tel.: +91 9437197816. Adres email: rachitapaedia@gmail.com (R. Sarangi). PEPO-401; No. of Pages 4 Please cite this article in press as: Sarangi R, et al. Clinical profile of scrub typhus in children treated in a tertiary care hospital in eastern India. Pediatr Pol. (2016), http://dx.doi.org/10.1016/j.pepo.2016.04.005 Dostępne online www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/pepo http://dx.doi.org/10.1016/j.pepo.2016.04.005 0031-3939/© 2016 Polish Pediatric Society. Published by Elsevier Sp. z o.o. All rights reserved.