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Case Report: Concurrent Sympatric Scrub Typhus and Japanese Spotted Fever in Japan.

Scrub typhus and Japanese spotted fever-both rickettsial diseases-are endemic and notifiable in Japan and may cause a fatal outcome without prompt treatment. Here we present the first case of a concurrent sympatric infection of both diseases with grade II evidence. A 67-year-old woman, after a single event of potential exposure to the pathogens, presented with a 12-day history of fever, pharyngeal pain, papulo-erythematous rash, and pronounced fatigue. Her erythematous rash was distributed on her trunk and extremities, palms, and soles and eventually progressed to purpura. Fever persisted unti…

Genetic variants of Orientia tsutsugamushi identified from scrub typhus cases in Malaysia.

We report herein the clinical presentation and diagnosis of scrub typhus in three patients attending a teaching hospital in Malaysia. Three genetic variants belonged to the Karp and Gilliam strains of O. tsutsugamushi were amplified from the acute blood samples of the patients by a nested polymerase chain reaction assay. The circulation of different genetic variants of O. tsutsugamushi strains might complicate the presentation and severity of scrub typhus. Loop-PCR is a promising diagnostic tool for rapid diagnosis of scrub typhus.

Tsutsugamushi Disease (Scrub Typhus) Meningoencephalitis in North Eastern India: A Prospective Study.

BACKGROUND: Scrub typhus is rampant in northern, eastern, and southern India. Central nervous system involvement in the form of meningitis or meningoencephalitis is common in scrub typhus. As specific laboratory methods remain inadequate or inaccessible in developing countries, prompt diagnosis is often difficult. AIM: The aim of this study was to characterize neurological complications in scrub typhus from northeastern region of India. SUBJECTS AND METHODS: We did a prospective study of scrub meningoencephalitis at North Eastern Indira Gandhi Regional Institute of Medical Sciences among pat…

Differentiating dengue virus infection from scrub typhus in Thai adults with fever.

Dengue fever and scrub typhus are common infections in Asia that often present as acute febrile illness of unclear etiology. We prospectively evaluated febrile adults presenting to the outpatient department of a hospital in northern Thailand to attempt to identify distinguishing characteristics between the two infections. Fifty-four patients were infected with scrub typhus and 35 were infected with dengue virus. Dengue virus infection was associated with hemorrhagic manifestations, particularly bleeding from the gums, which was reported by 27% of the dengue patients, but by none of the scrub t…

Diagnosis of scrub typhus in Malaysian aborigines using nested polymerase chain reaction.

A rapid diagnostic system for scrub typhus using nested polymerase chain reaction (PCR) was applied to clinical samples from Malaysian Aborigines. Whole blood from twenty-four patients suspected of scrub typhus infection were tested using nested polymerase chain reaction and sera were evaluated by the indirect immunoperoxidase test. Antibody responses towards Rickettsia tsutsugamushi were observed in seventeen patients with the majority having high titers of IgG antibodies. Seven patients were seronegative. The nested PCR amplified R. tsutsugamushi DNA from six patients, of which two were nega…

Осложнение синдрома острого дыхательного расстройства: сообщение о двух случаях.

Scrub tihus — зоонотическая болезнь, вызванная Рикитсией цуцугамуши, в которой люди являются случайными хозяевами. Хотя это острое фебрилическое заболевание, серьезные осложнения, связанные с этим заболеванием, весьма редки после введения специальной антибиотической терапии. Авторы сообщают о двух случаях скруба тифа, усугубляющего острый респираторный синдром. В первом случае произошло несколько отказов органов, и пациент истек. Во втором случае пациент вылечился и был выписан. Эти два случая доказали, что они являются тифом для скруба в силу их путешествий или их проживания в эндемической ме

Совпадение в аннотации оригинала
Scrub typhus is a zoonotic disease, caused by Rickettsia tsutsugamushi, in which humans are accidental hosts. Although it is an acute febrile illness, severe complications of this disease are very rare since the introduction of specific antibiotic therapy. The authors report two cases of scrub typhus complicating acute respiratory distress syndrome. The firs…

Molecular epidemic survey on co-prevalence of scrub typhus and marine typhus in Yuxi city, Yunnan province of China.

BACKGROUND: Human rickettsioses are worldwide zoonoses and it is not easy to differentiate them from other infectious diseases because of their atypical manifestation. In recent years the number of patients with fever of unknown causes from Hongta District CDC, Yuxi city of Yunnan Province has been increasing significantly in the summer. Diagnosis of scrub typhus was made by local clinicians. In order to ascertain the disease, we undertook a laboratory investigation for such patients from August 18 to 26, 2005. METHODS: Active surveillance was conducted by Hongta District CDC Yuxi city of Yun…

Dengue and scrub typhus coinfection in pregnancy: A rare case with multiorgan dysfunction.

Tropical infections continue to cause significant morbidity and mortality in India. While mixed tropical infections are relatively common in the general population, they are rare during pregnancy. We report a 24-year-old pregnant woman with a history of previous lower segment caesarean section and preeclampsia, who developed dengue and scrub typhus infection near-term. The illness was complicated by multiple organ dysfunction syndrome, yet with timely multidisciplinary management, both maternal and neonatal outcomes were favourable. Literature on such mixed tropical infections in pregnancy rem…

Plasma and Intracellular Concentrations of Doxycycline and Azithromycin in Patients with Severe Scrub Typhus.

BACKGROUND/OBJECTIVES: Scrub typhus, a life-threatening infection caused by Orientia tsutsugamushi, is treated with doxycycline or azithromycin. In severe disease, combination therapy with azithromycin and doxycycline had better clinical outcomes than either drug alone. However, it is not clear what causes the improved efficacy. To understand the same, we examined the plasma concentrations, intracellular concentrations, and efficacy of doxycycline, azithromycin, and both drugs in combination in 51 patients with severe scrub typhus. METHODS: A randomly selected subset of adult (>18 years) part…

Maternal and Fetal Outcomes Associated With Scrub Typhus in Pregnancy: A Systematic Review.

Scrub typhus, caused by Orientia tsutsugamushi and transmitted by larval trombiculid mites, is endemic across much of the Asia-Pacific region. It is frequently missed or misdiagnosed in pregnant individuals, where its consequences may be severe. Despite the severe maternal and fetal risks associated with scrub typhus, a comprehensive synthesis of the infection's total burden during pregnancy remains a critical gap in the literature. We searched five bibliographic databases (PubMed, CINAHL, MEDLINE Ultimate, ClinicalKey, and Ovid Embase), four trial registries (World Health Organization Interna…

Clinical Profile and Long-Term Outcomes of Scrub Typhus Meningoencephalitis in Children.

INTRODUCTION: Scrub typhus is a significant cause of acute encephalitis syndrome (AES) in pediatric populations, particularly in northern India. Its long-term outcomes have not been well studied to date. This study investigates the clinical profile and long-term outcomes of scrub typhus meningoencephalitis in children. METHODS: This prospective observational study was conducted at King George's Medical University, Uttar Pradesh, India, from August 2018 to October 2020. Children aged 0.3 months to 14 years who presented with AES were tested for scrub typhus using serum IgM Enzyme-Linked Immuno…

Evaluation of diagnostic accuracy of the novel Scrub Typhus IgM ELISA Kit.

BACKGROUND: Scrub typhus (ST) is a rickettsial infection endemic in Southeast Asia, with diagnostic challenges due to its clinical overlap with other febrile illnesses. Due to its accessibility and ease of use, Enzyme-linked Immunosorbent Assay (ELISA) is the widely preferred diagnostic tool. OBJECTIVES: This study aims to evaluate the diagnostic performance of the Scrub typhus IgM Microlisa kit (J. Mitra & Co Pvt., Ltd.,) for detecting ST IgM antibodies, using the Scrub Typhus Detect™ IgM ELISA (Inbios International, Inc.) as a reference standard. METHODS: A retrospective observational stud…

Scrub typhus masquerading as acute acalculous cholecystitis in a child - a case report.

We describe a case of scrub typhus in a 12-year old boy who presented with symptoms mimicking acute acalculous cholecystitis. He tested positive for anti-scrub typhus IgM antibodies. Treatment with oral azithromycin led to significant improvement and resolution of symptoms. Thus it is important to consider scrub typhus as a differential diagnosis for an acute abdomen in endemic areas. Timely diagnosis may avoid unnecessary suffering.

Scrub Typhus and Dengue Co-infection in an Adolescent Girl: A Diagnostic Challenge.

Scrub typhus and dengue fever are common infectious diseases in tropical regions, and both have overlapping clinico-epidemiological and laboratory features, which often pose a diagnostic challenge. This case report discusses a 15-year-old girl from the Indian subcontinent who presented with acute undifferentiated febrile illness (AUFI) without typical features of any of the common tropical infections. She was diagnosed with co-infection of scrub typhus and dengue fever using laboratory tests with good diagnostic accuracy. The patient was managed on an ambulatory basis, treated with oral doxycy…