Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 26 , ISSUE 6 ( June, 2022 ) > List of Articles


Pediatric Scrub Typhus Manifesting with Multisystem Inflammatory Syndrome: A New Cause for Confusion or Concern—A Case Series

Rajender Singh

Keywords : Child, Multisystem inflammatory syndrome in children, Rickettsia, Scrub typhus, Severe acute respiratory syndrome

Citation Information : Singh R. Pediatric Scrub Typhus Manifesting with Multisystem Inflammatory Syndrome: A New Cause for Confusion or Concern—A Case Series. Indian J Crit Care Med 2022; 26 (6):723-727.

DOI: 10.5005/jp-journals-10071-24200

License: CC BY-NC 4.0

Published Online: 20-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has discovered a new disease called multisystem inflammatory syndrome in children (MIS-C). In developing nations, pediatricians must be mindful of the similarities between MIS-C and other tropical fevers such as scrub typhus. Not only should such patients be kept on high alert to rule out tropical diseases and receive appropriate treatment, such as steroids or immunomodulatory medications, but this is also concerning because, if rickettsial or bacterial infection is not detected through cultures and serology, steroid, or immunomodulatory treatment alone can be fatal.

  1. Sonthayanon P, Chierakul W, Wuthiekanun V, Phimda K, Pukrittayakamee S, Day NP, et al. Association of high Orientia tsutsugamushi DNA loads with disease of greater severity in adults with scrub typhus. J Clin Microbiol 2009;47(2):430–434. DOI: 10.1128/JCM.01927-08.
  2. Bonell A, Lubell Y, Newton PN, Crump JA, Paris DH. Estimating the burden of scrub typhus: a systematic review. PLoS Negl Trop Dis 2017;11(9):e0005838. DOI: 10.1371/journal.pntd.0005838.
  3. Rathi N, Rathi A. Rickettsial infections: Indian perspective. Indian Pediatr 2010;47(2):157–164. DOI: 10.1007/s13312-010-0024-3.
  4. Gupta S, Bansal A, Biswal M, Williams V, Zaman K, Kumar A. Clinical profile and predictors of intensive care unit admission in pediatric scrub typhus: a retrospective observational study from North India. Indian J Crit Care Med 2020;24(6):445–450. DOI: 10.5005/jp-journals-10071-23445.
  5. Sood M, Sharma S, Sood I, Sharma K, Kaushik A. Emerging evidence on multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection: a systematic review with meta-analysis. SN Compr Clin Med 2021;3(1):38–47. DOI: 10.1007/s42399-020-00690-6.
  6. Shobhavat L, Solomon R, Rao S, Bhagat I, Prabhu S, Prabhu S, et al. Multisystem inflammatory syndrome in children: clinical features and management–intensive care experience from a pediatric public hospital in Western India. Indian J Crit Care Med 2020;24(11): 1089–1094. DOI: 10.5005/jp-journals-10071-23658.
  7. Burstein R, Henry NJ, Collison ML, Marczak LB, Sligar A, Watson S, et al. Mapping 123 million neonatal, infant and child deaths between 2000 and 2017. Nature 2019;574(7778):353–358. DOI: 10.1038/s41586-019-1545-0.
  8. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19 [Accessed October 15, 2021]. Available from:
  9. Indian Academy of Pediatrics (IAP)|get latest guidance on COVID-19 [Accessed October 23, 2021]. Available from:
  10. Yang J, Luo L, Chen T, Li L, Xu X, Zhang Y, et al. Efficacy and safety of antibiotics for treatment of scrub typhus. JAMA Netw Open 2020;3(8):e2014487. DOI: 10.1001/jamanetworkopen.2020.14487.
  11. Samprathi M, Narayanappa S, Sridhar M, Ramachandra P, Vemgal P. Multisystem inflammatory syndrome in children: a mimicker of severe dengue. Indian J Pediatr 2021;88(5):486–487. DOI: 10.1007/s12098-020-03550-2.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.