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Manifestation of acute peritonitis and pneumonedema in scrub typhus without eschar: A case report.

BACKGROUND: Scrub typhus is an acute infectious disease caused by rickettsia infection. The diagnosis is based on eschar, and clinical manifestations can range from asymptomatic to multiorgan dysfunction. CASE SUMMARY: We report the case of a 35-year-old man living in Zhuhai, Guangdong, China, who had repeated high fever with a maximum body temperature of 40.2 °C and elevated white blood cells and procalcitonin levels. After 7 d of persistent high fever, the patient developed rash, abdominal pain, and symptoms of peritonitis. Within 24 h after admission, the patient developed diffuse peritoni…

Association of Scrub Typhus With the Risk of Autoimmune Diseases: A Population-Based Cohort Study.

Infection plays a major role in the development of autoimmune diseases. In this study, we investigated the relationship between scrub typhus and systemic autoimmune diseases. We enrolled 6,928 hospitalized patients with scrub typhus between 2000 and 2012 from the Taiwan National Health Insurance Research Database, and we compared them with 27,712 selected inpatients who had never been diagnosed with scrub typhus (1:4 ratio, matched by age, sex, and index year) in relation to the risk of developing autoimmune diseases. Cox proportional hazards regression analysis was used to analyze the risk of…

Phylogenetic diversity of Orientia tsutsugamushi isolates in patients with scrub typhus in Bengaluru, India.

Scrub typhus has re-emerged as an important cause of acute febrile illness in India. There is a dearth of information on strain diversity of Orientia tsutsugamushi from Karnataka, India, hence the present study sought to address this issue. One hundred clinically suspected cases of scrub typhus/rickettsiosis (as per the DHR-ICMR guidelines) were included. Nested-polymerase chain reaction (PCR) for 56-kDa gene and phylogenetic analysis was performed. PCR was positive in 22 cases and phylogenetic analysis showed the presence of different strains, with predominance of clustering (57%) with Gillia…

[Feasibility of difference between hematocrit and albumin for identifying severity of scrub typhus disease].

OBJECTIVE: To explore the feasibility of difference between hematocrit and albumin (HCT-ALB) to evaluate the severity in patients with severe scrub typhus (Tsutsugamushi disease). METHODS: The clinical data of 408 patients with scrub typhus in 37 hospitals located in 15 prefectures of Yunnan Province from January 1st, 2017 to December 31st, 2018 were retrospectively collected. The patients were divided into the non-severe scrub typhus disease group (n = 265) and the severe scrub typhus disease group (n = 143) according to the diagnostic criteria. Volunteers attending Kunming City Medical Cent…

Kinetics of IgM and IgG antibodies after scrub typhus infection and the clinical implications.

OBJECTIVES: The serological detection of IgM antibodies is the most widely used test to diagnose scrub typhus infection. However, the kinetics of IgM and IgG antibodies post-infection remain elusive, which could contribute to false positivity. The objective of this study was to document the nature of the evolution of these antibody titres after infection. METHODS: Adult patients previously confirmed to have scrub typhus by IgM ELISA, positive PCR, or both, were included in this cross-sectional study. The levels of IgM and IgG antibodies in serum samples were tested using an ELISA and the dist…

Гемофагоцитический лимфохистиоцитоз с неврологическими проявлениями у младенца с скрубским тифом: редкий смертельный случай.

Гемофагоцитический лимфохистиоцитоз (HLH) — синдром неконтролируемой активации иммунной системы, приводящий к фагоцитозу кровяных клеток и распространению гистиотов в твердых органах. ГЛХ может быть первичным или вторичным по отношению к инфекционным, аутоиммунным и злокачественным заболеваниям. Scrub tyhus — инфекционная болезнь, вызванная цицугамуши, передающаяся клещей. Болезнь варьируется от легкой лихорадки с сыпью до тяжелой многосистемной болезни. Скруб тифа редко ассоциируется со вторичным HLH. Мы сообщали о младенце с скрубским тифом, который продвинулся в развитии HLH с участием цент

Совпадение в аннотации оригинала
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of unchecked activation of the immune system leading to phagocytosis of blood cells and proliferation of histiocytes in solid organs. HLH can be primary or secondary to infective, autoimmune and malignant conditions. Scrub typhus is an infective illness caused by Orientia tsutsugamushi, transmitted by mi…

Hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction.

BACKGROUND: Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. There is little attention given to hepatic impairment in the adults with scrub typhus. This study investigated the incidence and the prognostic implications of hepatic impairment in patients with scrub typhus. METHODS: We retrospectively reviewed a total of 143 adult patients with scrub typhus who were admitted between January 1999 and December 2010 in Guangdong province, China. The patients were divided into three groups, e.g., normal, mild, and moderate to severe groups based on the elevated…

Increased endothelial and macrophage markers are associated with disease severity and mortality in scrub typhus.

OBJECTIVES: Scrub typhus is endemic in the Asia-Pacific region. Mortality is high even with treatment, and further knowledge of the immune response during this infection is needed. This study was aimed at comparing plasma levels of monocyte/macrophage and endothelial related inflammatory markers in patients and controls in South India and to explore a possible correlation to disease severity and clinical outcome. METHODS: Plasma levels of ALCAM, VCAM-1, sCD163, sCD14, YKL-40 and MIF were measured in scrub typhus patients (n = 129), healthy controls (n = 31) and in infectious disease controls …

Epidemiology of scrub typhus and the eschars patterns in South Korea from 2008 to 2012.

In South Korea, scrub typhus is the most common acute febrile illness in autumn. We analyzed scrub typhus cases reported from 2008 to 2012 to describe the epidemiology of scrub typhus as well as eschar patterns. A total of 30,478 cases were reported from 2008 to 2012; the incidence rates were higher in the southern and western regions of South Korea. The common clinical symptoms of confirmed scrub typhus cases from 2010 to 2012 were fever/chills (95.2%), eschars (78.9%), and myalgia (61.7%). The primary sites of eschars were the lower extremities (19.0%), abdomen/waist (13.4%), and axilla (11.…

Life-threatening scrub typhus with hemophagocytosis and acute respiratory distress syndrome in an infant.

Scrub typhus is a rickettsial disease, caused by Orientia tsutsugamushi, which is transmitted via the bite of a chigger. This disease is one of the most important infectious diseases in the Asia-Pacific area; however, a severe infant case has not yet been reported. Here, we present the case of an 8-month-old boy with scrub typhus accompanied by hemophagocytic lymphohistiocytosis (HLH). His rapid course was complicated by acute respiratory distress syndrome (ARDS), status epilepticus and disseminated intravascular coagulation (DIC). He recovered after clarithromycin therapy and intensive suppor…

Scrub typhus in children at a tertiary hospital in southern India: clinical profile and complications.

OBJECTIVE: To study the clinical profile of and complications in children with scrub typhus. DESIGN: Prospective observational study. SETTING: Tertiary care hospital. METHODS: Children up to 12 years of age who had a fever for more than five days without an identifiable infection were included. All children who were suspected of having rickettsial infections were defined as having scrub typhus if they had a positive Weil-Felix test result (OX-K 1:80 or more) and one or more of the following clinical features (after exclusion of other diagnoses): rash, edema, hepatosplenomegaly, lymphadenopa…

Scrub typhus: an unrecognized threat in South India - clinical profile and predictors of mortality.

Scrub typhus is an important cause of acute undifferentiated febrile illnesses in the Indian subcontinent. Delay in diagnosis and in the initiation of appropriate treatment can result in severe complications such as acute respiratory distress syndrome (ARDS), septic shock and multisystem organ failure culminating in death. We conducted a prospective, observational study to delineate the clinical profile and predictors of mortality in scrub typhus in adults admitted to the medical wards of a tertiary care, referral hospital in South India over a one-year period. The case fatality rate in this s…

Passive transfer of scrub typhus plasma to patients with AIDS: a descriptive clinical study.

We examined the HIV-inhibitory effects previously found to be associated with scrub typhus infection. Individual 500 ml units of plasma from donors with mild scrub typhus were safety-tested, subjected to virucidal heat treatment, and administered to 10 HIV-1-infected recipients who were not receiving antiretroviral drugs. HIV-1 copy number fell three-fold or more in two recipients, and virus burden was reduced for 8 weeks in 70% (7/10) of recipients of a single plasma infusion, compared with the mean of three pre-infusion measurements. Scrub typhus donor plasma inhibited HIV-1 in vitro compare…

Transmission of Orientia tsutsugamushi, the aetiological agent for scrub typhus, to co-feeding mites.

Experiments were conducted to investigate the potential for transmission of Orientia tsutsugamushi, the aetiological agent for scrub typhus, when naturally infected mite larvae were co-feeding with uninfected larvae. Larvae from colonies of Leptotrombidium deliense and L. imphalum infected with O. tsutsugamushi were used. Transmission of O. tsutsugamushi to previously uninfected L. deliense and Blankaartia acuscutellaris co-fed with infected L. deliense was shown to occur. The overall minimum rate of acquisition was 1.6% (4/258) for L. deliense and 2.5% (3/119) for B. acuscutellaris. When indi…

Infection with human immunodeficiency virus does not influence the clinical severity of scrub typhus.

Infection by Orientia (formerly Rickettsia) tsutsugamushi causes scrub typhus, a severe febrile disease common in Asia. Both scrub typhus and AIDS are prevalent in northern Thailand. Therefore, we prospectively investigated the impact of infection due to human immunodeficiency virus (HIV) on the severity of the clinical syndrome produced by O. tsutsugamushi. The severity of scrub typhus was objectively graded on admission of patients to the hospital, and serologies for antibodies to HIV were performed. Fourteen (16%) of 86 patients with scrub typhus were infected with HIV; the median T helper …

Prevention of scrub typhus. Prophylactic administration of doxycycline in a randomized double blind trial.

We conducted a prospective randomized double blind study on the effects of doxycycline as a prophylactic antibiotic against scrub typhus. A total of 1,125 military subjects was followed for periods as long as 5 months of exposure in a hyperendemic focus in the Pescadores Islands of Taiwan. Oral 200 mg doses of doxycycline (Vibramycin) or placebo were given once each week throughout the trial. The incidence rate of scrub typhus in the placebo group was 2.5 times greater than that of the group taking doxycycline (P = 0.11). When subjects who failed to comply with scheduled administration of doxy…