title: Scrub typhus: audit of an outbreak.
abstract: OBJECTIVE
  To document the epidemiological, clinical and laboratory profile of all children with scrub typhus at a tertiary care centre in Chennai between September 2010 and June 2011.
  
  
  METHODS
  The case records of all children admitted and diagnosed with scrub typhus between September 2010 and June 2011 were analysed to look for salient clinical and laboratory parameters.
  
  
  RESULTS
  During the study period, 52 children were admitted with scrub typhus in the authors' hospital. The presenting complaints included fever in all cases. Other symptoms included swelling of legs (50 %) and vomiting (45 %). 13 % presented with CNS symptoms. The commonest physical findings included eschar (67 %), hepatomegaly (94 %), splenomegaly (73 %) and third spacing (67 %). Salient lab parameters included packed cell volume (PCV) <30 (48 %), leucocytosis (56 %), positive C-reactive protein (CRP) (92 %), hypoalbuminemia (79 %). Common complications included acute kidney injury (10 %) and peripheral gangrene (4 %). There was no mortality in the present case series.
  
  
  CONCLUSIONS
  The clinical profile of children with scrub typhus in a tertiary care centre is reported. Eschar and hepatosplenomegaly with a high CRP value is helpful in diagnosis. All patients responded well to the treatment.
authors.affiliation: Department of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital, 12A, Nageshwara Road, Nungambakkam, Chennai, 600034, India, mann_comp@hotmail.com.
authors.forename: Mani Ram
authors.initials: MR
authors.lastname: Krishna
authors.forename: B
authors.initials: B
authors.lastname: Vasuki
authors.forename: K
authors.initials: K
authors.lastname: Nagaraju
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D012285:Orientia tsutsugamushi / Q000302:isolation & purification; D012189:Retrospective Studies; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D063189:Symptom Assessment / Q000379:methods / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D004318:Doxycycline