Doxycycline-resistant Scrub Typhus in a Syndromic Child
Scrub Typhus, a human febrile illness caused by Orientia tsutsugamushi, is common in Asia and infects persons those visiting the endemic areas. Scrub typhus is a zoonotic infection. It is transmitted by a trombiculid mite which introduces the bacteria by its bite. Scrub typhus is associated with mac...
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JCDR Research and Publications Private Limited
2023-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/17452/59478_CE[Ra1]_F(SS)_PF1_(AKA_SS)_PFA(OM)_PN(SHU).pdf |
| _version_ | 1827990604619972608 |
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| author | Priya Margaret S Ramitha Enakshi Kumar V Revathi |
| author_facet | Priya Margaret S Ramitha Enakshi Kumar V Revathi |
| author_sort | Priya Margaret |
| collection | DOAJ |
| description | Scrub Typhus, a human febrile illness caused by Orientia tsutsugamushi, is common in Asia and infects persons those visiting the endemic areas. Scrub typhus is a zoonotic infection. It is transmitted by a trombiculid mite which introduces the bacteria by its bite. Scrub typhus is associated with maculopapular rashes and local and/or generalised lymphadenopathy.It is characterised by eschar at the site of the bite. A child with doxycycline-resistant scrub typhus is being presented here. A 10-year-old female child was bought to the hospital with complaints of fever for six days, cough for three days, loose stools for two days, and vomiting for one day duration. S1 and S2 sounds were heard while bilateral vesicular breath sounds were normal. There was no hepatosplenomegaly and Central Nervous System (CNS) examination showed no focal neurologic deficits. Investigations showed a normal leukocyte count and Differential Leucocyte Count (DLC), microcytic hypochromic anaemia, thrombocytopenia, hyponatremia, and elevated liver enzymes. Scrub Immunoglobulin M (IgM) was positive. Chest radiograph showed a bell-shaped chest with vertical straightening of ribs. The child was started on intravenous (i.v.) fluids, Doxycycline 4 mg/kg, and paracetamol. The child continued to spike fever at day 6 of Doxycycline and hence was started on Azithromycin 10 mg/kg, following which the fever subsided and the child was discharged. |
| first_indexed | 2024-04-10T00:37:18Z |
| format | Article |
| id | doaj.art-487fcf97d92644d7b23b95c9f2924bea |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T00:37:18Z |
| publishDate | 2023-02-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-487fcf97d92644d7b23b95c9f2924bea2023-03-14T09:35:41ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-02-01172SD01SD0410.7860/JCDR/2023/59478.17452Doxycycline-resistant Scrub Typhus in a Syndromic ChildPriya Margaret0S Ramitha Enakshi Kumar1V Revathi2Assistant Professor, Department of Paediatrics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.Third Year MBBS student, Department of Paediatrics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, India.Assistant Professor, Department of Paediatrics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.Scrub Typhus, a human febrile illness caused by Orientia tsutsugamushi, is common in Asia and infects persons those visiting the endemic areas. Scrub typhus is a zoonotic infection. It is transmitted by a trombiculid mite which introduces the bacteria by its bite. Scrub typhus is associated with maculopapular rashes and local and/or generalised lymphadenopathy.It is characterised by eschar at the site of the bite. A child with doxycycline-resistant scrub typhus is being presented here. A 10-year-old female child was bought to the hospital with complaints of fever for six days, cough for three days, loose stools for two days, and vomiting for one day duration. S1 and S2 sounds were heard while bilateral vesicular breath sounds were normal. There was no hepatosplenomegaly and Central Nervous System (CNS) examination showed no focal neurologic deficits. Investigations showed a normal leukocyte count and Differential Leucocyte Count (DLC), microcytic hypochromic anaemia, thrombocytopenia, hyponatremia, and elevated liver enzymes. Scrub Immunoglobulin M (IgM) was positive. Chest radiograph showed a bell-shaped chest with vertical straightening of ribs. The child was started on intravenous (i.v.) fluids, Doxycycline 4 mg/kg, and paracetamol. The child continued to spike fever at day 6 of Doxycycline and hence was started on Azithromycin 10 mg/kg, following which the fever subsided and the child was discharged.https://jcdr.net/articles/PDF/17452/59478_CE[Ra1]_F(SS)_PF1_(AKA_SS)_PFA(OM)_PN(SHU).pdfazithromycinhyponatremiaimmunoglobulin m |
| spellingShingle | Priya Margaret S Ramitha Enakshi Kumar V Revathi Doxycycline-resistant Scrub Typhus in a Syndromic Child Journal of Clinical and Diagnostic Research azithromycin hyponatremia immunoglobulin m |
| title | Doxycycline-resistant Scrub Typhus in a Syndromic Child |
| title_full | Doxycycline-resistant Scrub Typhus in a Syndromic Child |
| title_fullStr | Doxycycline-resistant Scrub Typhus in a Syndromic Child |
| title_full_unstemmed | Doxycycline-resistant Scrub Typhus in a Syndromic Child |
| title_short | Doxycycline-resistant Scrub Typhus in a Syndromic Child |
| title_sort | doxycycline resistant scrub typhus in a syndromic child |
| topic | azithromycin hyponatremia immunoglobulin m |
| url | https://jcdr.net/articles/PDF/17452/59478_CE[Ra1]_F(SS)_PF1_(AKA_SS)_PFA(OM)_PN(SHU).pdf |
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