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Establishing an external quality assurance scheme for the detection of Orientia tsutsugamushi IgM in clinical samples: Strengthening quality control of scrub typhus diagnosis in Indian laboratories.

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease that is associated with significant morbidity and mortality in many parts of India. Early and accurate diagnosis, primarily through the detection of IgM antibodies, plays a pivotal role in patient management and disease surveillance. However, there is a paucity of diagnostic methods in our country, and only in recent years have more diagnostic assays been rolled out. To address the heterogeneity in the laboratory diagnosis of scrub typhus, an external quality assurance scheme (EQA Scheme) for the detection of O t…

Rapidly Progressive Cytophagic Histiocytic Panniculitis in a Child Triggered by Trauma and Scrub Typhus: A Dramatic Response to Cyclosporine.

Cytophagic histiocytic panniculitis (CHP) is a rare and potentially life-threatening inflammatory panniculitis characterized by lobular lymphohistiocytic infiltration and cytophagic "bean-bag" histiocytes. Because its early features overlap with infectious panniculitis and hemophagocytic lymphohistiocytosis (HLH), diagnosis is often delayed, contributing to significant morbidity. We describe a rapidly progressive pediatric case of CHP triggered by antecedent trauma and scrub typhus infection. A 10-year-old girl presented with seven days of high-grade fever and painful erythematous nodules over

Как отличить педиатрический энтеровиральный менингоэнцефалит от скруба тифа менингоэнцефалита: одноцентральное ретроспективное исследование из провинции Юньнань, Китай.

В сезон эпидемии летом-осенью педиатрический скруб тиф (ST) и энтеровиральный менингоэнцефалит (EV), часто встречающийся с совпадающими клиническими проявлениями и рутинными цереброспинарными жидкостями (CSF), что затрудняет раннюю дифференционную диагностику и замедляет соответствующее лечение. Практические диагностические стратегии, основанные на легкодоступных параметрах, отсутствуют. ЦЕЛЬ: Оценка того, могут ли общие клинические и лабораторные показатели проводить различие между педиатром ST менингоэнцефалитом и ЭВ менингоэнцефалитом.МЕТОДЫ: Это одноцентральное ретроспективное когортное ис

Сопутствующая селезенка и почечная инфарктация в скруб-тифе: расширение васкулитического спектра.

Скруб тифа — зоонотическая инфекция, вызванная цетуцугамуши, которая характеризуется системным васкулитом и многоорганическим участием. Хотя печеночная, легочная и почечная дисфункция хорошо известны, ишемическая инфарктация твердых органов является явно редкостью. КИСЛОТА: 35-летняя женщина, которая ранее была здоровой, страдала острым фебриальным заболеванием, респираторными симптомами и болью в животе в левом верхнем квадрате. Проверка показала, что брюшная нежность тахипнея, гипоксии и фокуса без сыпания или эшара. Лабораторная оценка показала, что нейтрофильный лейкоцитоз, тромбоцитопенси

Совпадение в аннотации оригинала
BACKGROUND: Scrub typhus is a mite-borne zoonotic infection caused by Orientia tsutsugamushi, characterized by systemic vasculitis and multiorgan involvement. While hepatic, pulmonary, and renal dysfunction are well recognized, ischemic infarction of solid organs is distinctly uncommon. CASE PRESENTATION: A 35-year-old previously healthy woman presented with…

A Study on Prevalence of Malarial Retinopathy among Malaria Cases and to Determine Its Presence as a Marker of Severe Malaria: Observations from Eastern India.

BACKGROUND: Malarial retinopathy refers to a constellation of changes seen in severe or complicated malaria cases. These include: retinal whitening, vessel changes-whitening, tramlining, retinal hemorrhages, and papilledema. There are very few Indian studies on this entity. Since retina can be easily visualized by direct ophthalmoscopy, this study was done to determine prevalence of malarial retinopathy among malaria cases and to determine relationship between malarial retinopathy and severity of the disease. MATERIALS AND METHODS: The study was done at Indoor and Outdoor Departments of Tropi

Evaluation of Oral Doxycycline, Azithromycin, or Sequential Doxycycline-Azithromycin Treatment for Scrub Typhus.

BACKGROUND: Scrub typhus is a leading cause of febrile illness across the Asia-Pacific region. Doxycycline is the first-line therapy, with azithromycin as an alternative; sequential treatment (doxycycline followed by azithromycin) is used for nonresponders. However, comparative real-world effectiveness for sequential therapy remains uncertain. METHODS: We conducted a single-center, non-interventional target-trial emulation at the 970th Hospital of the People's Liberation Army (January 2023 - June 2025). Consecutive patients ≥12 years receiving oral doxycycline, azithromycin, or sequential dox

Differentiating scrub typhus meningitis from brucellar meningitis in children: A single-center retrospective study.

OBJECTIVE: To investigate the clinical distinctions between scrub typhus meningitis and brucellar meningitis in children, and to identify potential biomarkers with early differential diagnostic value to support clinical decision-making. METHODS: A retrospective analysis was conducted on 13 pediatric patients diagnosed with brucellar meningitis admitted to Kunming Children's Hospital over the past decade. Thirteen cases of scrub typhus meningitis were selected as controls using an age- and sex-matching strategy. The clinical manifestations, laboratory findings, and cerebrospinal fluid (CSF) ch

From obstacles to opportunities: Innovations and evolution of strategies in scrub typhus vaccine research.

Scrub typhus, caused by the obligate intracellular bacterium Orientia tsutsugamushi, remains a major public health burden in the Asia-Pacific region and is increasingly reported beyond its traditional endemic range. Despite its clinical significance, progress toward vaccine has been limited, largely due to extensive antigenic diversity and the difficulty of inducing durable cross-protective immunity. This review attempts to retrace the historical path of scrub typhus vaccine development from whole-cell killed preparations to subunit proteins, recombinant constructs, and epitope-driven strategi…

Understanding the spatiality in neglected tropical diseases: An ethnographic study of scrub typhus in Puducherry, India.

Individuals from marginalised backgrounds are often "placed" in spatial planes marked by disadvantages and poor resource availability, impacting their health outcomes. This study explored the role of spatiality in shaping health outcomes, with scrub typhus-a neglected tropical disease (NTD) of zoonotic origin-as an illustrative case. Employing a spatial justice framework, the study investigated the intersection of geospatial and socio-spatial factors influencing health and illness experience in Puducherry, India. An interdisciplinary mixed-methods approach was employed, involving geospatial ho

DNA barcoding reveals cryptic diversity in chiggers (Trombiculidae) parasitizing small mammals across Peninsular Malaysia.

Chiggers (Acariformes: Trombiculidae) are ectoparasites of small mammals and important vectors of scrub typhus, yet their taxonomy and molecular diversity in Southeast Asia remain poorly resolved. This study represents the first DNA barcoding and phylogenetic assessment of chiggers from small mammals across Peninsular Malaysia, integrating mitochondrial (COI) and nuclear (28 S rDNA) genes. A total of 192 chiggers representing 11 morphospecies from six genera were sequenced, with tree topologies inferred using maximum likelihood and supported by multiple species delimitation methods. The COI ge

Longitudinal immune cell dynamics and heterogeneous trajectories in children with scrub typhus: a descriptive pilot study.

BACKGROUND: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The dynamic characteristics of immune responses in children with scrub typhus remain unclear. METHODS: Eight children with confirmed scrub typhus were enrolled in this study. Peripheral blood samples were collected sequentially before and after treatment. Absolute counts of B cell, T cell, dendritic cell, monocyte, and natural killer (NK) cell subsets were measured by multicolor flow cytometry. Linear mixed models and ordinary linear regression analyses were performed to evaluate the dynamics of immune param…

Tsutsugamushi Hepatopathy: A Scoping Review.

Scrub typhus, caused by Orientia tsutsugamushi, is a significant public health concern, particularly in endemic regions of Asia. This mite-borne disease, transmitted by chiggers, presents with varied clinical manifestations, ranging from mild symptoms to severe complications, including multi-organ failure. Hepatic dysfunction is a common and often underappreciated clinical feature in scrub typhus patients, with recent studies highlighting its frequent occurrence. This dysfunction is characterized by elevated liver enzymes, jaundice, and, in severe cases, fulminant hepatic failure, often mimick…

Development and application of NanoLuc-based LIPS assay for antibody detection of orthohantavirus infections and vaccine responses.

Orthohantavirus (OHV), recognized by the WHO as prioritized pathogens with a high risk of Public Health Emergency of International Concern, could cause severe diseases such as hemorrhagic fever with renal syndrome (HFRS), and poses a persistent public health threat, particularly in China, where Hantaan virus (HTNV) and Seoul virus (SEOV) are endemic. Moreover, newly discovered species such as Luxi virus and Fugong virus pose a potential threat, further underscoring the need for improved surveillance. To address the limitations of current methods, e.g., narrow detection windows and biosafety co

Dried Serum Spots for External Quality Assurance of Scrub Typhus IgM Serology: A Multicentre Pilot Study From India.

OBJECTIVE: Scrub typhus, caused by Orientia tsutsugamushi , is a significant contributor to acute undifferentiated febrile illness in South and Southeast Asia. Laboratory confirmation of infection has a crucial role in timely management; nevertheless, lack of standardisation in inter-laboratory performance of IgM enzyme-linked immunosorbent assay (ELISA) has been a long-standing challenge. In resource-constrained countries, quality assurance schemes have an important role in improving laboratory performance. The aim of this pilot study was to assess the applicability of dried serum spots (DSS)…

Diagnostic Value of Neutrophil CD64 in Differentiating Scrub Typhus From Febrile Diseases.

BACKGROUND: Scrub typhus, lacks specific early symptoms, and traditional serological tests have low sensitivity. This study shows that CD64 has superior diagnostic performance compared to CRP and PCT in bacterial infections. METHODS: This retrospective study analyzed 242 febrile patients admitted to the Jiangsu Province (Suqian) Hospital (January 2023-December 2024), categorized into non-specific fever (n = 186) and scrub typhus (n = 56). The CD64 expression was quantified via flow cytometry (BD FACS Canto II) within 48 h of admission. ROC analysis evaluated diagnostic performance using AUC,

Pyrexia of Unknown Origin (PUO) in South Asia: A Systematic Review of Diagnostic Gaps and Management Strategies.

BACKGROUND: Pyrexia of Unknown Origin (PUO) represents a persistent diagnostic challenge in clinical practice. In South Asian regions, this challenge is compounded by a high burden of endemic infections, resource constraints, and varied clinical practices. This systematic review aimed to synthesize the available evidence on the etiology, diagnostic approaches, management, and systemic barriers related to PUO in the region to inform improved clinical guidelines and health policies. METHODS: A systematic literature search was conducted in major electronic databases following PRISMA 2020 guideli

A Compact Closed Genome of Orientia tsutsugamushi from Hainan Island, China Provides a TA763_A Reference and Reveals Repeat-Driven Remodeling.

Scrub typhus, caused by the obligate intracellular bacterium Orientia tsutsugamushi (O. tsutsugamushi), remains a major public-health concern in the Asia-Pacific region. Genome-wide inference is complicated by extensive repetitive DNA and frequent genome rearrangement. We isolated O. tsutsugamushi HMU_001 from a scrub typhus patient on Hainan Island, China. Intracellular morphology was examined and replication was quantified in endothelial cells. Using long-read sequencing with short-read polishing, we generated a closed circular genome and performed standardized comparative analyses across al…

Host response signatures across sepsis aetiologies in India: a single centre observational study.

BACKGROUND: Characterising the host response in sepsis is essential to understand its biological heterogeneity and to inform more precise di … ompared to viral sepsis, notable variation was found within these microbial categories. Orientia tsutsugamushi (causing scrub typhus) triggered the most profound host response alterations among bacterial causes, whereas viral haemorrhagic fever (dengue, Kyasanur forest disease) causing pathogens induced higher biomarker levels across all pathophysiologi …

MRI Brain Findings and Clinical Spectrum of Children With Typhus-Positive Acute Encephalitis Syndrome: Associations With Neurological Sequelae.

Background Scrub typhus, caused by Orientia tsutsugamushi through chigger bites, is a significant cause of acute encephalitis syndrome (AES) in children in Southeast Asia.  Materials and methods This cross-sectional study was conducted in the pediatric intensive care unit (PICU) of a tertiary care hospital in Gorakhpur district, Uttar Pradesh, India, over one year, from October 2021 to September 2022. Result Among 274 AES patients screened, 144 (52.55%) tested positive for scrub typhus via enzyme-linked immunosorbent assay (ELISA). Half of the affected patients were aged 1-5 years. MRI abnorma…