The second generation metagenomic sequencing of cerebrospinal fluid for diagnosis of non-eschar scrub typhus.

Tsutsugamushi disease, is an infectious disease transmitted by ticks and caused by the rickettsiella. It is characterized by eschar, fever, rash, and flu-like symptoms. However, diagnosing atypical cases without an eschar and with negative Weil-Felix test results poses a significant diagnostic challenge. This study presents a noteworthy case of non-eschar typhus which was effectively diagnosed using advanced next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) samples.