Observational studyPloS one2019
Clinical profile, complications and outcome of scrub typhus in children: A hospital based observational study in central Nepal.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Systematic review of the scrub typhus treatment landscape: Assessing the feasibility of an individual participant-level data (IPD) platform.PLoS neglected tropical diseases · 2021Pooled it
- Clinical features and risk factors for severe pediatric scrub typhus in Liangshan Prefecture, China: A retrospective cohort study.BMC pediatrics · 2026Article
- Antibiotic Antagonism inInfection & chemotherapy · 2026Review
- CKD in Migrants: From Epidemiology to Challenges.Kidney international reports · 2026Review
- Article
- Development and validation of a simple-to-use nomogram for predicting severe scrub typhus in children.PLoS neglected tropical diseases · 2025Article
- Recurrent acute appendicitis after recovery from scrub typhus that was associated with hemophagocytic lymphohistiocytosis and other severe complications in children: a case report.Frontiers in medicine · 2025Article
- Predictors of mortality in scrub typhus: A hospital-based study.Journal of family medicine and primary care · 2024Article
- Once Forgotten Now Re-emerging: Scrub Typhus Infection in Pediatric Patients From North West India.Cureus · 2023Article
- Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India.Cureus · 2023Article
- Clinical profile and outcomes of pediatric scrub typhus associated with elevated hepatic transaminases.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023Article
- Scrub Typhus in Paediatric Age Group at a Tertiary Care Centre of Eastern India: Clinical, Biochemical Profile and Complications.Journal of family medicine and primary care · 2022Article
- The Search for Effective Empiric Therapy for Acute Undifferentiated Febrile Illness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Profile of Scrub Typhus Meningitis/Meningoencephalitis in Children with and without Scrub Typhus IgM Antibody in CSF.Journal of neurosciences in rural practice · 2021Article
- Comparative Study of Chikungunya Only and Chikungunya-Scrub Typhus Coinfection in Children: Findings from a Hospital-Based Observational Study from Central Nepal.International journal of pediatrics · 2021Article
- A Systematic Review and Meta-analysis of Scrub Typhus and its Association with Liver Disease.Journal of global infectious diseasesArticle
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScrub typhus, an important cause of unexplained fever, is grossly neglected and often misdiagnosed in low and middle income countries like Nepal. The main aim of this study was to report on the clinical profile and complications of scrub typhus and its outcome in Nepalese children.
methodsA prospective observational study was carried out in children aged 1-16 years, admitted to a tertiary care hospital of central Nepal in between July 2016- Aug 2017. Scrub typhus was diagnosed with IgM ELISA.
resultsAll cases of scrub typhus (n = 76) presented with fever and commonly had other symptoms such as headache (75%), myalgia (68.4%), vomiting (64.5%), nausea (59.2%), abdominal pain (57.9%), cough (35.5%), shortness of breath (22.4%), altered sensorium (14.5%), rashes (13.2%) and seizures (11.8%). Important clinical signs noticed were lymphadenopathy (60.5%), hepatomegaly (47.4%), edema (26.3%), jaundice (26.3%), and splenomegaly (15.8%). About 12% (n = 9) had necrotic eschar. Similarly, thrombocytopenia, raised liver enzymes and raised creatinine values were seen in 36.9%, 34.2% and 65.8% respectively. The most common complications were myocarditis (72.4%), hypoalbuminemia (71.1%), severe thrombocytopenia (22.4%), renal impairment (65.8%), hyponatremia (48.7%) and hepatitis (34.2%). Over two-thirds (69.70%) of the cases were treated with doxycycline followed by combination with azithromycin in the remaining 18.4%. Overall, mortality rate in this group was 3.9%.
conclusionsScrub typhus should be considered as a differential in any community acquired acute undifferentiated febrile illness regardless of the presence of an eschar. Myocarditis and acute kidney injury are important complications which when addressed early can prevent mortality. Use of doxycycline showed a favorable outcome.
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