title: Paediatric scrub typhus in Thailand: a study of 73 confirmed cases.
abstract: We studied 73 Thai children with scrub typhus (median age 9 years, range 3-14 years, male:female ratio 1.8:1). Most patients (86%) lived in rural areas. They presented with subacute fever (median, 9 d) with vomiting (35%), hepatomegaly (59%), splenomegaly (18%), and tachypnea (26%). Skin rash (7%), eschar (7%), and history of mite bite were rare. Blood leucocyte counts were usually normal but 19% of patients were thrombocytopenic. Twenty (22%) patients had pneumonia and six (8%) had neurological involvement. Defervescence occurred a median of 1 d and 3 d after initiation of doxycycline and chloramphenicol, respectively, and these responses were more rapid than in those who received other antibiotics or no treatment (P < 0.001). There was one death. Only 55% of the patients were initially diagnosed as having scrub typhus.
authors.affiliation: Department of Paediatrics, Hat-yai Hospital, Hat-yai, Songkla, Thailand.
authors.forename: Kamkarn
authors.initials: K
authors.lastname: Silpapojakul
authors.forename: Boonyarat
authors.initials: B
authors.lastname: Varachit
authors.forename: Khachornsakdi
authors.initials: K
authors.lastname: Silpapojakul
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012423:Rural Health; D012612:Scrub Typhus / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents