{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T14:40:06Z","timestamp":1746628806618,"version":"3.40.5"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Scrub typhus is one of the common causes for acute febrile illness in monsoon and post-monsoon season in our region. It usually presents as fever, rash, and thrombocytopenia with or without multiorgan dysfunction syndrome (MODS). Infrequently, it can cause focal or symmetrical peripheral gangrene (SPG). Here, we report a 5-year-old female who presented with acute febrile illness with MODS and SPG in bilateral lower limbs. The diagnosis of scrub typhus was confirmed with positive scrub typhus IgM antibodies. She recovered completely after combination therapy with doxycycline and azithromycin, and organ supportive therapy (mechanical ventilation, vasoactive drugs, and continuous renal replacement therapy) in the pediatric intensive care unit.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0801","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T15:46:51Z","timestamp":1741103211000},"page":"1113-1115","source":"Crossref","is-referenced-by-count":0,"title":["Symmetrical Peripheral Gangrene in an Indian Child with Severe Scrub Typhus"],"prefix":"10.4269","volume":"112","author":[{"given":"Prasanna","family":"Samynathan","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Meena","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Biswal","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh Kumar","family":"Angurana","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Infect Public Health","first-page":"82","article-title":"Scrub typhus in children at a tertiary hospital in southern India: Clinical profile and complications","volume":"5","author":"Kumar","year":"2012"},{"key":"b2","series-title":"Indian J Crit Care Med","first-page":"445","article-title":"Clinical profile and predictors of intensive care unit admission in pediatric scrub typhus: A retrospective observational study from North India","volume":"24","author":"Nallasamy","year":"2020"},{"key":"b3","series-title":"Emerg Infect Dis","first-page":"402","article-title":"Molecular detection of candidatus orientia chuto in wildlife, Saudi Arabia","volume":"29","author":"Alkathiry","year":"2023"},{"key":"b4","series-title":"Emerg Infect Dis","first-page":"2148","article-title":"Molecular description of a novel orientia species causing scrub typhus in Chile","volume":"26","author":"Abarca","year":"2020"},{"key":"b5","series-title":"J Clin Microbiol","first-page":"4404","article-title":"Isolation of a novel Orientia species (O. chuto sp. nov.) from a patient infected in Dubai","volume":"48","author":"Izzard","year":"2010"},{"key":"b6","series-title":"Pediatr Crit Care Med","first-page":"e44","article-title":"Hemophagocytic lymphohistiocytosis in a PICU of a developing economy: Clinical profile, intensive care needs, outcome, and predictors of mortality","volume":"22","author":"Parajuli","year":"2021"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"194","article-title":"Etiology of acute encephalitis syndrome in adults in a tertiary care center in Eastern Uttar Pradesh","volume":"112","author":"Rai","year":"2024"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"497","article-title":"Digital gangrene associated with scrub typhus: A case series","volume":"110","author":"Singh","year":"2024"},{"key":"b9","series-title":"Cureus","first-page":"e64981","article-title":"Various presentations of scrub typhus: A case series","volume":"16","author":"Saini","year":"2024"},{"key":"b10","series-title":"J Clin Diagn Res","first-page":"PR01","article-title":"Rickettsial fever presenting with gangrene: A case series","volume":"11","author":"Prasannan","year":"2017"},{"key":"b11","series-title":"Pediatr Infect Dis J","first-page":"e249","article-title":"Indian tick typhus presenting as gangrene: A case report","volume":"42","author":"Dash","year":"2023"},{"key":"b12","series-title":"Pediatr Infect Dis J","first-page":"e312","article-title":"Acral gangrene: Ugly cousin of \u201cCOVID toes\u201d in multisystem inflammatory syndrome in children associated with SARS-CoV-2?","volume":"40","author":"Chaudhary","year":"2021"},{"key":"b13","series-title":"J Postgrad Med Edu and Res","first-page":"177","article-title":"Peripheral limb gangrene in neonates","volume":"55","author":"Sundaram","year":"2021"},{"key":"b14","series-title":"Cureus","first-page":"e58117","article-title":"Relationship between symmetrical peripheral gangrene patients and using vasopressors in the intensive care unit","volume":"16","author":"Alhumam","year":"2024"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/112\/5\/article-p1113.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/112\/5\/article-p1113.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/112\/5\/article-p1113.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T14:24:38Z","timestamp":1746627878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/112\/5\/article-p1113.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,7]]},"references-count":14,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0801","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,5,7]]}}}