Background : Rickettsial infections are re–emerging in the Indian subcontinent. Due to their diagnostic dilemma the onset of treatment is delayedespecially in children. There is a need for understanding clinic epidemiological profile which will facilitate early diagnosis and management.

Objectives: To describe the epidemiology, clinical and laboratory profile of spotted fever among children in a tertiary care hospital in Kolar. 

Methodology: Children aged <18yrs hospitalized with clinically–diagnosed rickettsial fever were reviewed retrospectively. 

Results: Among 196 children hospitalized between January 2013–December 2017, median age was five years, and 57.6% were male children. Mean duration of fever was 9.7 days. Rash was present in 92.7% (182/196) of children, involving palms and soles. Severe complications were seen in 22.7% (purpura fulminans,4.5%; meningitis and meningoencephalitis, 6.1%; septic shock, 4.5%; acute respiratory distress syndrome, 1.0%:pneumonia, 6.1%; gastrointestinal bleed, 0.5%). Positive Weil–Felix test results were seen in 80.2% of cases. Patients were treated with doxycycline and more than half showed defervescence within 36 hours.

Conclusions: This analysis from southern India shows that the burden of rickettsial infection among children in India is high, with a substantially high complication rate. Thus, indicating the need for increasing awareness for early diagnosis and management of these infections.