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Neurological Manifestations of Scrub Typhus: The Clinical Spectrum, Determinants, and Outcome.

BACKGROUND AND OBJECTIVE: Neurological involvement is reported in up to a quarter of patients with scrub typhus. However, prospective studies accurately describing clinical findings, temporal evolution, and rare syndromes are sparse. This study characterized scrub typhus-associated neurological syndromes, emphasizing neurological localization, clinical outcomes, and potential predictors. MATERIALS AND METHODS: This prospective cohort study included patients admitted to a medical college hospital with scrub typhus during a 1-year period. Detailed clinical, laboratory, and radiological profiles…

Vertical transmission of scrub typhus: a case report of congenital infection.

Scrub typhus (ST), caused by Orientia tsutsugamushi, is typically transmitted through mite bites, but vertical transmission from mother to infant remains poorly understood. This case presents a 13-day-old female neonate diagnosed with congenital ST. The infant developed severe systemic involvement, including fever, jaundice, respiratory distress, and signs of hemophagocytic lymphohistiocytosis (HLH). Despite broad-spectrum antibiotic therapy, her condition worsened. PCR and serological tests confirmed the diagnosis of ST in both the neonate and the mother, with IgM positivity indicating congen…

Neglected and lethal: Case series of fatal scrub typhus in Malaysia.

Scrub typhus (ST), an often-underdiagnosed zoonotic infection, poses significant diagnostic and management challenges, particularly in regions with endemic tropical infections like Malaysia. We report three fatal cases of ST in central region West Malaysia, highlighting diagnostic pitfalls and implications for clinical management. Three fatal cases of ST presented with respiratory distress and multiorgan failure were reported in this study. Laboratory investigations confirmed by positive Orientia tsutsugamushi (OT) PCR results. All three cases exhibited low PCR cycle threshold (Ct) values, sug…

Scrub Typhus: An Acute Precipitant for Acute on Chronic Liver Failure.

Acute-on-chronic liver failure (ACLF) is a clinical syndrome with high mortality. Many acute precipitating factors have been implicated in triggering the acute event of ACLF, with bacterial infections being a common precipitant. However, many other precipitants can cause ACLF; therefore, identification of these factors early in the golden window and their treatment can result in improved prognosis. Scrub typhus usually presents as uncomplicated acute febrile illness but rarely as complicated. Few case reports of scrub-typhus-induced acute liver failure have been reported but none with scrub-ty…

Global seroprevalence of scrub typhus: a systematic review and meta-analysis.

Scrub typhus, a neglected disease, is a significant health concern in the Tsutsugamushi triangle of the Asia-Pacific and has raised global concerns due to recent cases occurring outside this region. To estimate the global prevalence of scrub typhus, we conducted a systematic review and meta-analysis. We conducted a systematic search of PubMed, Scopus, and Embase databases for observational studies on scrub typhus. Using a random-effects model, we combined the prevalence estimates with inverse-variance weights while also evaluating heterogeneity and publication bias. Among 3551 reports screened…

Double Blow in the Tropics: A Case of Concurrent Leptospirosis and Scrub Typhus.

A 34-year-old male, with no history of known previous disease, employed at a ginger farm in South India, presented with a four-day history of high-grade fever and headache. Initially, he received symptomatic treatment but was referred due to hypotension and persistent fever. Investigations showed leucocytosis, thrombocytopenia, abnormal liver function tests, renal dysfunction, and elevated C-reactive protein. Positive results were obtained for Leptospira immunoglobulin M (IgM) and scrub typhus IgM tests, indicating a coinfection, reported rarely from this region. Timely clinical suspicion, pro…

A Review of Rickettsial Diseases Other Than Scrub Typhus in India.

Rickettsial diseases (RD) are widely reported all over the world. Scrub typhus (ST) is a major tropical infection which is well documented all over India. Therefore, the index of suspicion of scrub typhus is high among physicians with regard to patients presenting with acute febrile illness (AFI) and acute undifferentiated febrile illness (AUFI) in India. Rickettsial diseases other than ST (non-ST RDs), which include spotted fever group (SFG) rickettsioses and typhus group (TG) rickettsioses are not uncommon in India, but the index of suspicion is not as high as ST unless there is a history of…

Acute Pancreatitis as a Rare Complication of Scrub Typhus: A Case Report.

Scrub typhus is transmitted by the bite of chiggers (larvae) of Leptotrombidium deliense and is caused by the bacteria Orientia tsutsugamushi. Common symptoms include fever, headache, lymphadenopathy, and black eschar formation, while acute pancreatitis is a rare complication. We present the case of a 27-year-old gentleman, who presented with epigastric pain and constipation for three weeks, fever for four days, and vomiting for two days. Serum lipase, C-reactive protein, and serum amylase were significantly raised. Enzyme-linked immunosorbent assay anti-scrub typhus IgM was positive at 0.605 …

Diagnostic challenges and antibody kinetics in a paediatric traveller with scrub typhus.

Diagnosing scrub typhus in travellers is challenging due to symptom similarities with other travel-related illnesses and limited early diagnostic tools. We present a distinctive case of scrub typhus in a child traveller, providing a comprehensive account of the case, the diagnostic challenges encountered, laboratory findings and the dynamics of antibodies.

Coinfection With Severe Fever With Thrombocytopenia Syndrome and Scrub Typhus in Korea.

BACKGROUND: Scrub typhus and severe fever with thrombocytopenia syndrome (SFTS) are the 2 most common tick-borne infectious diseases in Korea. Every year, an increasing number of cases are reported, which is a public health concern. Therefore, we aimed to investigate the prevalence of SFTS-scrub typhus coinfection in patients with SFTS. METHODS: Clinical samples were collected from 129 patients with SFTS. One-step reverse-transcription polymerase chain reaction (PCR) was performed to identify the SFTS virus (SFTSV), and real-time PCR followed by nested PCR was performed to detect the Orientia…

An outbreak investigation of scrub typhus in Nepal: confirmation of local transmission.

BACKGROUND: Scrub typhus is a largely ignored tropical disease and a leading cause of undifferentiated febrile illness in the areas of tsutsugamushi triangle caused by Orientia tsutsugamushi. It is frequently diagnosed in South Asian countries, although clear epidemiological information is not available from Nepal. After the 2015 earthquake in Nepal, a sudden upsurge in scrub typhus cases was reported. The objective of this study was to investigate epidemiology of scrub typhus and its causative agents in humans, animals, and chigger mites to understand the ongoing transmission ecology. METHOD…

Evaluation of the Diagnostic Accuracy of Antibody Assays for Patients with Scrub Typhus.

This study was carried out to evaluate the accuracy of various antibody tests for scrub typhus, namely, the indirect immunofluorescence assay (IFA) from the Korea Centers for Disease Control and Prevention (KCDC) and four commercial kits (companies A to D). The test accuracy was based on the diagnosis of scrub typhus, as defined by a positive PCR or culture. In total, serum samples from 97 patients with scrub typhus and 200 non-scrub typhus patients were tested. The respective sensitivity and specificity of each test were as follows. For the KCDC IFA, sensitivity and specificity were 55.7% (95…

Clinical Manifestations and Outcome of Scrub Typhus in Infants From Odisha.

OBJECTIVE: To study manifestations and outcome of scrub typhus in infants. METHODS: Case record analysis of infants with scrub typhus admitted to a tertiary care hospital, diagnosed by IgM ELISA from January 1, 2016 to December 31, 2019. RESULTS: Out of 374 children diagnosed with scrub typhus, 34 (9%) were infants. Chief presentation were fever 34 (100 %), feeding difficulty 24 (70.6%), lethargy 18 (52.9%) and irritability 15 (44.1%). Clinically, pallor 30 (88.2%), tachycardia 29 (85.3%), tachypnea 24 (70.6%), hepatosplenomegaly 30 (88.2%) and eschar 6 (17.6%) were detected. Significant lab…

The 100 top-cited articles on scrub typhus: a bibliometric analysis.

OBJECTIVE: The aims of this study were to analyze the characteristics of the 100 top-cited articles on scrub typhus (ST), and to assess the present research landscape and future research directions using bibliometric analysis. METHODS: Web of Science was used to conduct a bibliometric analysis of the 100 top-cited articles on ST. The articles were analyzed by publication year, number of citations, document type, journals, keywords, institutions, country of origin, and authorship. RESULTS: The top 100 articles on ST were published between 1945 to 2017. The number of citations ranges from 39 t…

The Early Diagnosis of Scrub Typhus by Metagenomic Next-Generation Sequencing.

Introduction: Scrub typhus is a mite-borne infection widespread in Southeast Asia, with clinical symptoms such as fever, chills, skin rash, eschar at the bite site, and other signs of acute febrile illness. The Rickettsia pathogen (Orientia tsutsugamushi) is always difficult to be diagnosed at an early stage by traditional clinical diagnostic methods, especially for patients without typical eschar. This greatly increases the mortality of patients with scrub typhus. A new approach should be introduced to improve its clinical diagnosis. Methods: During May 2018 to March 2021, 13 samples from 10 …

Скруб тифа в качестве редкой причины острого пьелонефрита: сообщение по делу.

КОЛИЧЕСТВО: Скруб тифа может иметь нетипичные признаки и симптомы, такие, как острые повреждения почек, гастроэнтерит, пневмонит и острый респираторный синдром. Сообщалось также о менингите, энцефалите и дисфункции печени, особенно в тяжелых случаях с многосистемным участием. В литературе никогда не сообщалось о том, что скруб тифа вызывает инфекцию мочевого тракта, которая включает в себя цитит и пиролонэприт. КИСЛОТА: 45-летний мужчина, подающий в амбулаторное отделение с лихорадкой, болью в правой части пашины и горящими поражением в течение трех дней, был первоначально очищен от УТИ. Однак

Совпадение в аннотации оригинала
BACKGROUND: Scrub typhus can present with atypical signs and symptoms such as those of acute kidney injury, gastroenteritis, pneumonitis, and acute respiratory distress syndrome. Meningitis, encephalitis, and hepatic dysfunction have also been reported, particularly in severe cases with multisystem involvement. Scrub typhus has never been reported in the lit…