Evidence map›Paper›PMID 39903427›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025

Eschar is not the sole clue for scrub typhus: a retrospective analysis of pediatric scrub typhus without eschars.

Yonghan Luo, Xiaotao Yang, Houxi Bai, Litao Xiao, Yan Guo, Feng Jiao, Yanchun Wang

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Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yonghan LuoSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China.
Xiaotao YangSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China.
Houxi BaiSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China.
Litao XiaoSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China.
Yan GuoFaculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.
Feng JiaoSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China.
Yanchun WangSecond Department of Infectious Disease, Kunming Children's Hospital, Yunnan Key Specialty of Pediatric Infection (Training and Education Program)/Kunming Key Specialty of Pediatric Infection, Kunming, Yunnan, 650000, China. wangyanchun0204@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to investigate the clinical characteristics and analyze the diagnostic approaches employed for pediatric cases of scrub typhus (ST) that present without eschars.

methodsA retrospective analysis was conducted on 256 ST cases hospitalized at Kunming Children's Hospital in Yunnan Province, China, from January 2015 to November 2022. Patients were categorized into an eschar group (n = 213) and a non-eschar group (n = 43). Clinical data were collected and analyzed for significant differences between the groups. This study particularly highlights the diagnostic methods for confirming ST in cases without eschars.

resultsThe non-eschar group exhibited a higher incidence of pneumonia, a lower history of outdoor activities prior to onset, and a longer hospital stay; however, the remaining clinical and laboratory characteristics did not show statistically significant differences. The most common site for eschar formation was the axilla (12.7%, n = 27), followed by the groin (9.4%, n = 20) and auricle (8.9%, n = 19). Other notable sites included the scalp (7.5%, n = 16) and shoulder (6.6%, n = 14). The Weil-Felix test (OXK) demonstrated a positivity rate of 69.7% (23 out of 33 cases), cerebrospinal fluid (CSF) PCR had a positivity rate of 50.0% (3 out of 6 cases), and blood PCR exhibited a positivity rate of 92.3% (24 out of 26 cases).

conclusionThese findings underscore the importance for clinicians to consider ST in pediatric patients, even in the absence of eschars. A comprehensive evaluation based on epidemiology, symptoms, signs, and laboratory characteristics is essential. Blood PCR testing methods are recommended. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Scrub TyphusAdolescentChildChild, PreschoolChinaFemaleHumansInfantMaleOrientia tsutsugamushiRetrospective StudiesClinical characteristicsDiagnostic challengesEscharPediatricsScrub typhus

Identifiers

PMID39903427

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.