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. 2025 Feb 15;17(2):e79055.
doi: 10.7759/cureus.79055. eCollection 2025 Feb.

Clinical Profile and Long-Term Outcomes of Scrub Typhus Meningoencephalitis in Children

Hricha Mishra  1 , Chandra Kanta  1 , Amita Jain  2 , Ravindra Kumar Garg  3 , Shantanu Prakash  2 , Rajkumar Kalyan  2
Affiliations

Clinical Profile and Long-Term Outcomes of Scrub Typhus Meningoencephalitis in Children

Hricha Mishra et al. Cureus. .

Abstract

Introduction: Scrub typhus is a significant cause of acute encephalitis syndrome (AES) in pediatric populations, particularly in northern India. Its long-term outcomes have not been well studied to date. This study investigates the clinical profile and long-term outcomes of scrub typhus meningoencephalitis in children.

Methods: This prospective observational study was conducted at King George's Medical University, Uttar Pradesh, India, from August 2018 to October 2020. Children aged 0.3 months to 14 years who presented with AES were tested for scrub typhus using serum IgM Enzyme-Linked Immunosorbent Assay (ELISA) and polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) and peripheral blood mononuclear cells (PBMC). Positive patients were followed up for one year to assess long-term neurological outcomes.

Results: Of 264 children tested for scrub typhus, 78 (29.5%) were positive. Neurological symptoms included altered sensorium (70 (89.74%)), seizures (69 (88.46%)), and focal neurological deficits 8 (10.26%). Hepato-splenomegaly (27 (34.61%)), thrombocytopenia (48 (61.5%)), and raised liver transaminases (51 (65.4%)) were the other common manifestations. Mortality occurred in 10.25% of cases. Sixty-seven cases were followed up for one year. Long-term outcomes indicated that 60 (89.55%) of the patients fully recovered, while seven (10.45%) experienced sequelae, including minor impairment in four (5.97%), moderate impairment in two (2.99%), and severe impairment in one case (1.49%).

Conclusion: Scrub typhus is a major cause of AES in children, with significant neurological sequelae in a small number of cases.

Keywords: acute encephalitis syndrome (aes); children; clinical presentation; meningoencephalitis; outcome; scrub typhus.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, King George's Medical University, India issued approval 89 ECM II B-PhD/P3. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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