Pediatric Scrub Typhus Follow-up

  • Author: David J Cennimo, MD, FACP, FAAP, AAHIVS; Chief Editor: Russell W Steele, MD   more...
 
Updated: Mar 30, 2012
 

Further Inpatient Care

  • Inpatient care may be necessary for patients with severe scrub typhus.
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Further Outpatient Care

  • Relapse may occur and require additional courses of antibiotics.[27]
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Deterrence/Prevention

  • Preventive measures in endemic areas include protective clothing and insect repellents.
  • Short-term vector reduction using environmental insecticides and vegetation control can be instituted.
  • Chemoprophylaxis using doxycycline in high-risk groups (eg, military personnel) has been successful. Doses are weekly and must be started before exposure and continued for 6 weeks after exposure.[40]
  • No vaccine for scrub typhus is available.
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Prognosis

  • Prognosis varies and depends on the severity of illness, which relates to the different strains of O tsutsugamushi as well as host factors.
  • Severe disease is uncommon with antimicrobial treatment.
  • Incomplete immunity and strain heterogeneity opens the door to frequent reinfections. Immunity to the same strain is believed to last 3 years whereas immunity to other strains may last as little as 1 month; although repeat infections may be attenuated.[1]
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Contributor Information and Disclosures
Author

David J Cennimo, MD, FACP, FAAP, AAHIVS  Assistant Professor of Medicine and Pediatrics, Adult and Pediatric Infectious Diseases, Co-Director Physician's Core, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

David J Cennimo, MD, FACP, FAAP, AAHIVS is a member of the following medical societies: American Academy of HIV Medicine, American Academy of Pediatrics, American College of Physicians, American Medical Association, HIV Medicine Association of America, Infectious Diseases Society of America, Medical Society of New Jersey, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Coauthor(s)

Arry Dieudonne, MD  Associate Professor of Pediatrics, Division of Pulmonology, Allergy, Immunology and Infectious Diseases, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Clinical Director, Francois-Xavier Bagnold Center for Children, University Hospital

Arry Dieudonne, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

José Rafael Romero, MD  Director of Pediatric Infectious Diseases Fellowship Program, Associate Professor, Department of Pediatrics, Combined Division of Pediatric Infectious Diseases, Creighton University/University of Nebraska Medical Center

José Rafael Romero, MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, New York Academy of Sciences, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Aracelis D Fernandez, MD, FAAP, and Rosemary Johann-Liang, MD, to the original writing and development of this article.

References

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A transmission electron micrograph depicting a peritoneal mesothelial cell of a mouse that had been experimentally infected intraperitoneally with Orientia tsutsugamushi rickettsial micro-organisms. In this photomicrograph, several organisms are visible within the mesothelial cell's cytoplasm. O tsutsugamushi is the cause of scrub typhus.
Eschar on the neck.
Eschar on the scrotum.
Typical eschar.
Maculopapular rash.
Image of a chigger. Image taken from "Food and Environmental Hygiene Department" Web site and is reproduced under license from the Government of Hong Kong Special Administrative Region.
 
 
 
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