{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:56:26Z","timestamp":1790880986190,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background &amp; objectives:<\/jats:title>\n                    <jats:p>\n                      Scrub typhus (ST), a tropical infection caused by\n                      <jats:italic toggle=\"yes\">Orientia tsutsugamushi<\/jats:italic>\n                      , has re-emerged as a global concern in the Asia-Pacific region. Limited data on ST in infants reveals unique presentations, complications, and severity predictors. This study was conducted to evaluate the occurrence of ST in infants, comparing clinical, laboratory and outcomes with ST in older children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a prospective cohort study conducted in the Pediatrics Department of a teaching hospital in South India. Children &lt;12 years of age presenting with fever for &gt;5 days with serology confirmed ST using IgM ELISA for ST were included after excluding other common tropical infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 650 children, 60 (10%) were infants. Fever (100%) was the most common presentation with mean duration of 9 days followed by cough and fast breathing. Eschar (33, 55%) was commonly seen in the face (14, 23.3%) and were atypical (10, 16.6%) in appearance. Findings such as pallor, oedema, hepatosplenomegaly, lung crackles and hematological abnormalities like anemia, leukocytosis, elevated transaminases were more prevalent in infants compared to older children. Severe ST was observed in 34 (56.7%) infants, commonly presenting with pneumonia and shock. Doxycycline showed quicker defervesence with no adverse events in infants. Logistic regression identified hypoalbuminemia as a significant predictor of severe ST in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation &amp; conclusion:<\/jats:title>\n                    <jats:p>ST in infants is common and poses a diagnostic challenge due to overlapping features with other tropical infections. Timely therapy and risk stratification can improve outcomes in resource limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jvbd.jvbd_8_25","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T06:00:27Z","timestamp":1749448827000},"page":"61-66","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Clinical profile and predictors of severity in infantile scrub typhus: A prospective observational study from a tertiary care teaching hospital in Southern India"],"prefix":"10.4103","volume":"63","author":[{"given":"Dinesh Kumar","family":"Narayanasamy","sequence":"first","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Karaikal, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thirunavukkarasu Arun","family":"Babu","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Mathiyalagen","sequence":"additional","affiliation":[{"name":"Indira Gandhi Medical College & Research Institute (IGMC&RI), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"issue":"1","key":"R2-20260302","doi-asserted-by":"crossref","first-page":"10895","DOI":"10.1038\/s41598-024-61555-9","article-title":"Global seroprevalence of scrub typhus: a systematic review and meta-analysis","volume":"14","author":"Dasgupta","year":"2024","journal-title":"Sci Rep"},{"issue":"12","key":"R3-20260302","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1007\/s12098-016-2171-6","article-title":"Clinico - Laboratory profile of scrub typhus - An emerging rickettsiosis in India","volume":"83","author":"Narayanasamy","year":"2016","journal-title":"Indian J Pediatr"},{"issue":"4","key":"R4-20260302","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s12098-023-04983-1","article-title":"Burden of pediatric scrub typhus at a tertiary care hospital: Clinical, biochemical, complications and predictors of mortality and morbidity","volume":"91","author":"G","year":"2024","journal-title":"Indian J Pediatr"},{"issue":"6","key":"R5-20260302","first-page":"472","article-title":"Clinical profile of scrub typhus meningoencephalitis among South Indian children","volume":"64","author":"Dinesh","year":"2018","journal-title":"J Trop Pediatr"},{"issue":"8","key":"R6-20260302","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s12098-018-2612-5","article-title":"Predictors of severity in pediatric scrub typhus","volume":"85","author":"Narayanasamy","year":"2018","journal-title":"Indian J Pediatr"},{"issue":"3","key":"R7-20260302","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s13312-017-1035-0","article-title":"IAP guidelines on rickettsial diseases in children","volume":"54","author":"Rathi","year":"2017","journal-title":"Indian Pediatr"},{"issue":"6","key":"R8-20260302","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s13312-020-1864-0","article-title":"Clinical profile of scrub typhus in newborns","volume":"57","author":"Samad","year":"2020","journal-title":"Indian Pediatr"},{"issue":"12","key":"R9-20260302","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.3201\/eid2412.180695","article-title":"Risk Factors for acquiring scrub typhus among children in Deoria and Gorakhpur Districts, Uttar Pradesh, India, 2017","volume":"24","author":"Thangaraj","year":"2018","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"R10-20260302","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1186\/s12879-019-4299-2","article-title":"Risk factors for acquisition of scrub typhus in children admitted to a tertiary centre and its surrounding districts in South India: A case control study","volume":"19","author":"Rose","year":"2019","journal-title":"BMC Infect Dis"},{"key":"R11-20260302","doi-asserted-by":"crossref","first-page":"1251746","DOI":"10.3389\/fped.2023.1251746","article-title":"Congenital scrub typhus: A case report and literature review","volume":"11","author":"Liang","year":"2023","journal-title":"Front Pediatr"},{"issue":"4","key":"R12-20260302","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s13312-021-2198-2","article-title":"Clinical manifestations and outcome of scrub typhus in infants from Odisha","volume":"58","author":"Behera","year":"2021","journal-title":"Indian Pediatr"},{"issue":"2","key":"R13-20260302","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1093\/cid\/cir1065","article-title":"The Definition of pneumonia, the assessment of severity, and clinical standardization in the pneumonia etiology research for child health study","volume":"54","author":"Scott","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"12","key":"R14-20260302","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/S2213-2600(19)30249-8","article-title":"Challenges in the diagnosis of paediatric pneumonia in intervention field trials: recommendations from a pneumonia field trial working group","volume":"7","author":"Goodman","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"4","key":"R15-20260302","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4103\/ipcares.ipcares_152_22","article-title":"Neonatal scrub typhus with an eyelid eschar masquerading as \u201cLate-onset Sepsis\u201d","volume":"2","author":"Narayanasamy","year":"2022","journal-title":"Indian Pediatrics Case Reports"},{"issue":"7","key":"R16-20260302","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.4103\/jfmpc.jfmpc_2392_20","article-title":"Seroprevalence trends of scrub typhus among the febrile patients of Northern India: A prospective cross-sectional study","volume":"10","author":"Singh","year":"2021","journal-title":"J Fam Med Prim Care"},{"issue":"4","key":"R17-20260302","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s12098-020-03303-1","article-title":"Stye Can Lie! - A rare presentation of scrub typhus Eschar","volume":"88","author":"Narayanasamy","year":"2021","journal-title":"Indian J Pediatr"},{"issue":"2","key":"R18-20260302","doi-asserted-by":"crossref","first-page":"174","DOI":"10.4103\/ijpd.IJPD_109_20","article-title":"\u201cMite bite\u201d sign: A novel atypical eschar of pediatric scrub typhus","volume":"22","author":"Babu","year":"2021","journal-title":"Indian J Paediatr Dermatol"},{"issue":"11","key":"R19-20260302","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s12098-023-04793-5","article-title":"Neonatal Scrub Typhus: A Case Series","volume":"90","author":"Deglurkar","year":"2023","journal-title":"Indian J Pediatr"},{"issue":"2","key":"R20-20260302","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/pde.13048","article-title":"Characteristics of pediatric scrub typhus eschar in South Indian children","volume":"34","author":"Arun","year":"2017","journal-title":"Pediatr Dermatol"},{"issue":"6","key":"R21-20260302","article-title":"Neonatal scrub typhus: A series of five cases","volume":"17","author":"Vindhiya","year":"2023","journal-title":"J Clin Diagn Res"},{"issue":"4","key":"R22-20260302","doi-asserted-by":"crossref","first-page":"417","DOI":"10.4103\/0971-5916.159279","article-title":"DHR-ICMR Guidelines for diagnosis & management of Rickettsial diseases in India","volume":"141","author":"Rahi","year":"2015","journal-title":"Indian J Med Res"},{"issue":"5","key":"R23-20260302","article-title":"Prospective study to assess the response to therapy and its predictors in children with scrub typhus","volume":"67","author":"Arun","year":"2021","journal-title":"J Trop Pediatr"},{"issue":"3","key":"R24-20260302","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1177\/00494755211012585","article-title":"Clinical profile and predictors of severity in paediatric scrub typhus with pulmonary involvement","volume":"51","author":"Narayanasamy","year":"2021","journal-title":"Trop Doct"},{"issue":"2","key":"R25-20260302","doi-asserted-by":"crossref","first-page":"e0247584","DOI":"10.1371\/journal.pone.0247584","article-title":"Clinical significance of hypoalbuminemia in patients with scrub typhus complicated by acute kidney injury. Dass B, editor","volume":"16","author":"Oh","year":"2021","journal-title":"PLOS ONE"}],"container-title":["Journal of Vector Borne Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jvbd.jvbd_8_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:39Z","timestamp":1787837079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jvbd.jvbd_8_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jvbd.jvbd_8_25","relation":{},"ISSN":["0972-9062"],"issn-type":[{"value":"0972-9062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-01-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}