Scrub Typhus Pneumonia - A Forgotten Entity in Children: Case Report

Scrub typhus fever is widely reported in various parts of India. Rickettsial infections including scrub typhus are often missed due to non-specific presentation of its illness, limited knowledge, and awareness among clinicians and poor diagnosis facilities. It should be suspected in any child with fever more than 5 days with rash, edema, hepatosplenomegaly, lymphadenopathy, eschar, and tick bite or tick exposure. Pulmonary involvement of scrub typhus includes atypical pneumonia to serious cases showing dense airspace consolidation, pleural effusion, and acute respiratory distress syndrome. Only a few cases of scrub typhus pneumonia are reported in children. We report a 5-year-old child who presented with pneumonia involving both lungs and unilateral effusion who promptly responded with azithromycin and doxycycline.