title: Clinical profile of scrub typhus in children and its association with hemophagocytic lymphohistiocytosis.
abstract: OBJECTIVE
  To study the clinical profile of children with scrub typhus and its association with hemophagocytic lymphohistiocytosis.
  
  
  METHODS
  Children presenting with unexplained fever and multi-systemic involvement between May to December 2011 were tested for scrub typhus using IgM ELISA kits. Occurrence of Hemophagocytic lymphohistiocytosis in IgM positive cases of scrub typhus was studied.
  
  
  RESULTS
  Of the 35 children with unexplained fever and multi-systemic involvement, 15 children (9 boys) tested positive for scrub typhus. Thrombocytopenia, hypoalbuminemia and raised hepatic transaminases were observed in all children. Out of seven children evaluated for hemophagocytic lymphohistiocytosis. 3 met the criteria for hemophagocytosis. Two children (one with hemophagocytic lymphohistiocytosis) died.
  
  
  CONCLUSIONS
  Scrub typhus is a common cause of unexplained fever in children in northern India. Hemophagocytic lymphohistiocytosis can occasionally complicate scrub typhus in children.
authors.affiliation: Department of Pediatrics, PGIMER, Chandigarh; and *Department of Microbiology, Indira Gandhi Medical College, Shimla, India. Correspondence to: Prof. Sunit C Singhi, Professor and Head, Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India. sunit.singhi@gmail.com.
authors.forename: Naveen
authors.initials: N
authors.lastname: Sankhyan
authors.forename: L G
authors.initials: LG
authors.lastname: Saptharishi
authors.forename: Kandasamy
authors.initials: K
authors.lastname: Sasidaran
authors.forename: Anil
authors.initials: A
authors.lastname: Kanga
authors.forename: Sunit C
authors.initials: SC
authors.lastname: Singhi
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology