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Higher Acid-Base Imbalance Associated with Respiratory Failure Could Decrease the Survival of Patients with Scrub Typhus during Intensive Care Unit Stay: A Gene Set Enrichment Analysis.

Ninety percent of patients with scrub typhus (SC) with vasculitis-like syndrome recover after mild symptoms; however, 10% can suffer serious complications, such as acute respiratory failure (ARF) and admission to the intensive care unit (ICU). Predictors for the progression of SC have not yet been established, and conventional scoring systems for ICU patients are insufficient to predict severity. We aimed to identify simple and robust indicators to predict aggressive behaviors of SC. We evaluated 91 patients with SC and 81 non-SC patients who were admitted to the ICU, and 32 cases from the pub…

Acarological investigation and detection of Orientia tsutsugamushi (Rickettsiales: Rickettsiaceae) in field-collected chiggers (Acari: Trombiculidae) and small mammals from scrub typhus positive localities in Pahang, West Malaysia.

Scrub typhus (ST) is an acute febrile illness caused by Orientia tsutsugamushi (Hayashi, 1920) that is transmitted to humans through the bite of infected chiggers. In recent years, ST has re-emerged as a public health concern in Malaysia. In 2024, more than 50 laboratory-confirmed human cases of ST were reported in Pahang. A collaborative investigation was undertaken on a subset of 26 cases to identify potential vector sources and animal hosts associated with O. tsutsugamushi transmission. Chigger-based sampling was conducted by trapping small mammals in suspected infection hotspots, including…

Short report: detection of Orientia tsutsugamushi in clinical samples by quantitative real-time polymerase chain reaction.

Orientia tsutsugamushi infection causes scrub typhus, a common zoonosis of rural Asia. Orientia tsutsugamushi was recently detected by a real-time quantitative polymerase chain reaction (qPCR) assay in animal specimens. We evaluated the same qPCR assay in specimens obtained from patients with serologically proven scrub typhus infections. The 47-kDa qPCR assay was more sensitive than was mouse inoculation; it was reactive in whole blood specimens from all 10 isolate-positive patients and in 7 of 17 isolate-negative individuals (P = 0.003, Fisher's two-tailed exact test). As few as 1,076 O. tsut…

Rickettsia serosurvey in Kimberley, Western Australia.

To determine if antibodies to rickettsiae (scrub typhus, spotted fever, and typhus group rickettsiae) occur among persons living in the Kimberley (northern tropical) region of Western Australia, 920 sera collected in a non-random manner in 1996 from patients in Kununurra, Broome, Fitzroy Crossing, Wyndham, Derby, and Halls Creek were tested by micro-immunofluorescence for antibodies to a panel of rickettsial antigens. Of 920 sera examined, 52 (5.6%) were positive for antibodies to one or more of the three groups of rickettsial microorganisms. The largest group of sera (24; 2.6%) were positive …

Mixed genotypes of Orientia tsutsugamushi in conserved genes and a single immune-dominant tsa56 genotype discovered from a patient with scrub typhus in Hainan Island, China: a case report.

BACKGROUND: Orientia tsutsugamushi (O. tsutsugamushi), an obligate intracellular bacterium, is transmitted to humans through infected larval trombiculid mite bites, causing scrub typhus. Mixed genotypes of O. tsutsugamushi in canonical conserved genes were reported in 8-25% of blood samples from patients. Yet, there are few clinical descriptions of these mixed O. tsutsugamushi-infected patients. CASE PRESENTATION: We report a patient with scrub typhus complicated with pulmonary involvement and hepatic dysfunction, who carried mixed genotypes of the conserved genes but had a single immune-domi…

Scrub typhus in Puducherry, India: Application of nested PCR targeting three different genes - 56 kDa, 47 kDa and groEL of Orientia tsutsugamushi and comparison with ST IgM ELISA.

BACKGROUND & OBJECTIVES: Scrub typhus (ST), an important zoonosis caused by Orientia tsutsugamushi, is now prevalent throughout India. While demonstration of IgM antibody by Indirect Immunofluorescence Assay (IFA) is the gold standard serological test, IgM ELISA is an alternative. Demonstration of O. tsutsugamushi DNA in the blood or eschar confirms infection in the early febrile period. METHODS: Scrub typhus nested PCR (n-PCR) for 56 kDa, 47 kDa and groEL genes and ST IgM ELISA were performed for 210 clinically suspected ST patients. As healthy controls, 70 voluntary blood donors were includ…

Genetic typing of the 56-kDa type-specific antigen gene of contemporary Orientia tsutsugamushi isolates causing human scrub typhus at two sites in north-eastern and western Thailand.

Orientia tsutsugamushi is the causative agent of scrub typhus, a major cause of febrile illness in the rural areas of Southeast Asia. Twenty-three strains of O. tsutsugamushi were isolated from patients with scrub typhus in north-east (Udorn Thani province) and western Thailand (Tak province) between 2003 and 2005. The isolates were characterized by sequencing the entire ORF of the 56-kDa-type-specific antigen gene, followed by phylogenetic analysis. The majority (15/23) of isolates clustered with the Karp-type strain, six with a Gilliam-type strain and one each with the TA716- and TA763-type …

Comparison of Diagnostic Performance of Commercially Available Serological and Molecular Tests for Detection of Orientia tsutsugamushi in South Korea: A Single-Center Prospective Study.

Background: Scrub typhus is commonly misdiagnosed because of nonspecific clinical features and limited data on the performance of diagnostic tests. This study aimed to evaluate the accuracy of commercially available serological and molecular assays for diagnosing scrub typhus. Methods: Adult patients with suspected scrub typhus who visited a tertiary-care hospital in South Korea from July 2022 to December 2024 were prospectively enrolled. Scrub typhus was confirmed by either a positive real-time polymerase chain reaction (PCR) result for Orientia tsutsugamushi or a ≥ four-fold increase in the …

Foetal outcome of Leptospira and Rickettsial infections during pregnancy: a systematic review.

BACKGROUND: Leptospirosis and rickettsial infections are bacterial zoonoses prevalent in different geographical locations and presents with overlapping symptoms. OBJECTIVE: To identify foetal outcomes in pregnant women diagnosed with rickettsial infections, including scrub typhus and leptospirosis, along with their associated factors. METHODS: A comprehensive search was conducted in MEDLINE/PubMed, Scopus, CENTRAL (Cochrane), Web of Science, PsycINFO, Academic Search Premier, CINAHL, and Embase using defined search terms. Studies involving pregnant women with diagnosed leptospirosis and rick…

Comparative evaluation of the indirect immunoperoxidase test for the serodiagnosis of rickettsial disease.

An indirect immunoperoxidase test was compared with an indirect fluorescent antibody test and the Weil-Felix OXK test for serodiagnosis of scrub typhus by measuring the rickettsial antigen specific activity of IgG, IgM, and whole globulin. Acute and convalescent sera from 50 Rickettsia tsutsugamushi isolate-positive scrub typhus patients and from 45 febrile patients diagnosed as having diseases other than scrub typhus were tested. The receiver operating characteristic for each test showed that the indirect immunoperoxidase and indirect fluorescent antibody tests were more sensitive and specifi…

A Clinical Case of Scrub Typhus in the United States Forces Korea Patient with Eschar and Genetic Identification of Orientia tsutsugamushi Using Multiplex PCR-Based Next-Generation Sequencing.

An epidemiological investigation was conducted for a scrub typhus case reported in a U.S. Forces Korea military patient in the Republic of Korea in November 2018. The patient had a fever, maculopapular rash, and an eschar. The full-length sequence of Orientia tsutsugamushi 56-kDa type-specific antigen (TSA) gene was obtained from eschar tissue by multiplex PCR-based Next Generation Sequencing for genetic identification. Based on the 56-kDa TSA gene, the O. tsutsugamushi aligned most closely with the Boryong strain.

Как определить точность альтернативного диагностического теста, когда он на самом деле лучше эталонных тестов: переоценка диагностических тестов для скреба тифуса с использованием байесов.

ИСТОРИЯ ВОПРОСА: Косвенный анализ иммунофторации (IFA) считается эталонным испытанием для скруба тифа. Недавно в качестве эталонного стандарта для оценки альтернативных диагностических тестов были предложены критерии заражения тифом Scrub; сочетание культуры, PCR-анализов и IFA IgM. Здесь мы используем байезийские скрытые классные модели (LCM) для оценки истинной точности каждого диагностического теста и CNTC для диагностики скруба тифа. Данные о 161 пациенте с недифференцированной температурой были пересмотрены с использованием байесовских ЛХМ. Каждого пациента оценивали на предмет наличия эш

Совпадение в аннотации оригинала
BACKGROUND: The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true…

Rickettsial Cerebellitis: A Rare Neurological Manifestation.

Scrub typhus is a vector-borne disease caused by gram-negative bacilli, Orientia tsutsugamushi. The vector of scrub typhus is the mite. The clinical manifestations often present with either a simple fever or life-threatening multi-organ dysfunction. Neurological manifestations also vary, and the incidence of neurological manifestations is unknown. Cerebellitis is one of the rare neurological manifestations associated with scrub typhus. In this case report, we present the case of a 35-year-old man who tested positive for scrub typhus (IgM enzyme-linked immunosorbent assay (ELISA) blood test) wi…

Risk-factors for human infection with Orientia tsutsugamushi: a case-control study in Korea.

A case-control study was conducted involving 156 patients with scrub typhus and 130 controls. Three factors were associated significantly with the risk of developing scrub typhus: engaging in fruit farming (OR 2.44; 95% CI 1.04-5.69), gathering chestnuts (OR 2.05; 95% CI 1.09-3.87) and taking breaks in areas adjacent to agricultural operations (OR 3.06; 95% CI 1.50-6.22). In contrast, receiving information or educational materials concerning the prevention of scrub typhus had a protective effect (OR 0.45; 95% CI 0.24-0.83). These results suggest that a health education programme will lower the…

The role of tumor necrosis factor in host defense against scrub typhus rickettsiae. II. Differential induction of tumor necrosis factor-alpha production by Rickettsia tsutsugamushi and Rickettsia conorii.

The present study was undertaken to investigate the ability of members of two different groups of Rickettsia to stimulate macrophages or immune lymphocytes to produce TNF. It was found that R. conorii, a spotted fever group rickettsia, readily induced murine peritoneal macrophages or the macrophage-like cell line P388D1 to produce relatively high levels of TNF. The interaction of macrophages with viable organisms or heat-killed organisms resulted in TNF production. In contrast, viable or killed R. tsutsugamushi did not stimulate the production of detectable TNF even though viable organisms gre

An Unusual Etiology of Cerebellar Ataxia.

Cerebellar ataxia, which is the lack of coordination, has a number of causes none of which are as uncommon or unheard of as Scrub typhus. Scrub typhus very rarely presents itself with CNS manifestations. Here, we present the case of a 7-year-old girl from the Hooghly district in West Bengal, who presented to us with the history of fever, cerebellar signs, and sudden onset of visual loss. She was ultimately diagnosed with scrub typhus cerebellitis.

Epidemiology and ecology of rickettsial diseases in the People's Republic of China.

Since 1949, information on rickettsial diseases in the People's Republic of China has been virtually nonexistent in the West. This is the first comprehensive review of the ecology and epidemiology of Chinese rickettsial diseases to be published outside the People's Republic. At least five rickettsioses exist in China: scrub typhus, murine typhus, epidemic typhus, Q fever, and one or more spotted fever-group (SFG) rickettsioses. Although epidemic typhus has been controlled and scrub typhus has abated in many areas, murine typhus, Q fever, and SFG rickettsiosis are important public health proble…

Seroepidemiology of rickettsial infections in Northeast India.

BACKGROUND: Resurgence of scrub typhus was reported in Northeast India in 2010 after a gap of 67 years since World War II. However, the presence of other rickettsial infections remained unknown from this region. A seroepidemiological investigation was undertaken in the scrub typhus affected areas from 2013-2015 in Assam, Arunachal Pradesh and Nagaland to assess the exposure to other rickettsial diseases besides scrub typhus. METHODS: Samples were collected from people residing in scrub typhus reporting areas. Serology was performed by an indirect ELISA for the three rickettsial agents' viz., …

Анализ эпидемиологических характеристик четырех естественных фокальных заболеваний в провинции Шаньдун, Китай, 2009 - 2017 годы: описательный анализ.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Природные инфокальные заболевания являются серьезными заболеваниями, угрожающими здоровью человека. Они угрожают примерно 100 миллионам людей в провинции Шаньдун и ежегодно вызывают болезни у тысяч людей. Однако информация об эпидемиологических характеристиках естественных фокальных заболеваний в провинции Шаньдун является ограниченной. Цель этого исследования состояла в том, чтобы описать и проанализировать эпидемиологические характеристики естественных фокальных заболеваний в провинции Шаньдун, 2009 - 2017 годы. Мы описываем распространенность и распространение четырех

Совпадение в аннотации оригинала
BACKGROUND: Natural-focal diseases are serious diseases that endanger human health. They threaten about 100 million people in Shandong Provi … ere fever with thrombocytopenia syndrome (SFTS), human granulocytic anaplasmosis (HGA), typhus, and scrub typhus. The high-risk groups of the four diseases were farmers and the elderly. The incidence rate of scrub typhus was significantly higher in females. However, this difference was not seen in the other three diseases. The four diseases were mainly cluster …

Differential patterns of endothelial and leucocyte activation in 'typhus-like' illnesses in Laos and Thailand.

Scrub typhus is responsible for a large proportion of undifferentiated fevers in south-east Asia. The cellular tropism and pathophysiology of the causative agent, Orientia tsutsugamushi, remain poorly understood. We measured endothelial and leucocyte activation by soluble cell adhesion molecule enzyme-linked immunosorbent assays in 242 Lao and Thai patients with scrub or murine typhus, leptospirosis, dengue, typhoid and uncomplicated falciparum malaria on admission to hospital. Soluble E-selectin (sE-selectin) levels were lowest in dengue, sL-selectin highest in scrub typhus with a high sE-sel…