Analysis of clinical features and risk factors for severity in 42 cases of pediatric scrub typhus in Xiamen City
10.3760/cma.j.issn.1673-4912.2025.07.006
- VernacularTitle:厦门市42例儿童恙虫病临床特征和重症危险因素分析
- Author:
Xiaoqin WANG
1
;
Zhiqiang ZHUO
;
Jinqiang ZHANG
;
Dequan SU
Author Information
1. 厦门市儿童医院(复旦大学附属儿科医院厦门医院）6病区 361000
- Publication Type:Journal Article
- Keywords:
Tsutsugamushi disease;
Children;
Clinical features;
Risk factors
- From:
Chinese Pediatric Emergency Medicine
2025;32(7):509-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics and risk factors for the progression of severe scrub typhus in children.Methods:Clinical data, laboratory and auxiliary examination results, treatment and prognosis data of children with scrub typhus admitted to Xiamen Children's Hospital from July 2014 to March 2024 were collected. The clinical characteristics of scrub typhus in children were analyzed, and the study subjects were divided into severe group and mild group according to their condition. The relevant risk factors for progression to severe cases were analyzed.Results:A total of 42 cases were included, with 34 cases (80.95%) in the mild group and 8 cases (19.05%) in the severe group. All patients(100%) had fever, with the highest incidence of eschar or ulceration (95.24%), followed by lymphadenopathy and splenomegaly. All 42 patients improved or recovered after treatment with azithromycin or doxycycline, with no deaths reported. Compared with the mild group，the severe group had a higher incidence of cough, lymphadenopathy，and hepatomegaly, with statistically significant differences( P<0.05). Compared with the mild group, the severe group showed a decrease in hemoglobin(Hb), platelet, and fibrinogen(Fib) levels, while serum C-reactive protein(CRP), procalcitonin, aspartate aminotransferase, creatine kinase MB, and lactate dehydrogenase (LDH) levels increased, with statistically significant differences( P<0.05). Multivariate Tobit model analysis showed that a decrease in Hb ( OR -0.006，95% CI -0.012-0.000， P<0.05), an increase in CRP ( OR 2.72，95% CI 0.001-0.008， P=0.010), an increase in LDH ( OR 1.76，95% CI 0.000-0.000， P=0.027), and a decrease in Fib ( OR -3.78，95% CI -0.309-0.093， P=0.001) were risk factors for scrub typhus progressing to severe cases. Conclusion:During the epidemic season of scrub typhus, fever accompanied by eschar or ulceration, along with splenomegaly and lymphadenopath aids in the diagnosis of scrub typhus. Decreased Hb and Fib, as well as elevated CRP and LDH, are risk factors for the development of severe scrub typhus in children.
