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The estimated burden of scrub typhus in Thailand from national surveillance data (2003-2018).

BACKGROUND: Scrub typhus is a major cause of acute febrile illness in the tropics and is endemic over large areas of the Asia Pacific region. The national and global burden of scrub typhus remains unclear due to limited data and difficulties surrounding diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: Scrub typhus reporting data from 2003-2018 were collected from the Thai national disease surveillance system. Additional information including the district, sub-district and village of residence, population, geographical, meteorological and satellite imagery data were also collected for Chiangrai, the…

Anti-aquaporin-4 Antibody Positive Optic Neuritis Following Scrub Typhus in an Elderly Female.

INTRODUCTION: Aquaporin-4 antibody (AQP4-Ab) is specific for neuromyelitis optica spectrum disorder (NMOSD) and so is helpful to distinguish NMOSD from other autoimmune diseases. Several viral infections may play a role in the onset of NMOSD. CASE REPORT: We describe a case of a previous healthy 82-year-old woman who presented with acute visual loss occurring 3 weeks after scrub typhus. Physical examination showed a relatively afferent pupillary defect in the right eye and ophthalmoscopy revealed edema of the right optic disc. Enhanced magnetic resonance imaging revealed enhancement of the ri…

Clinical Profile and Complications of Scrub Typhus: Hospital-Based Study in Sub-Himalayan Region.

BACKGROUND: Scrub typhus is a documented disease in Himachal Pradesh, but there have been no clinico-epidemiological studies in this area. The present study is done with IgM ELISA as a diagnostic test which has higher sensitivity and specificity as most of previous studies had used Weil Felix test as a diagnostic test. METHODOLOGY: This was a prospective observational study. All the patients more than 18 years of age with positive IgM ELISA for scrub typhus with or without eschar were included. The clinical profile was observed. IgM scrub typhus was done by kit method manufactured by InBios I…

Bilateral simultaneous facial palsy following scrub typhus meningitis: a case report and literature review.

Scrub typhus is widely distributed across the Asia-Pacific region, Taiwan included. The clinical manifestations and complications of scrub typhus vary and the illness ranges in severity from mild to fatal. The etiology of facial nerve palsy varies and infectious agents have been associated with this condition. Rickettsiae species have, however, rarely been reported as the causative agents. We report the case of a 49-year-old man who had fever, malaise, headache, oligouria and tea-colored urine. Bilateral pneumonitis, acute renal failure, acalculous cholecystitis and aseptic meningitis were dia…

First report of an Orientia tsutsugamushi type TA716-related scrub typhus infection in Thailand.

Orientia tsutsugamushi causes scrub typhus and is a rural zoonosis endemic in the Asia Pacific region. This is the first report of O. tsutsugamushi TA716-like strain in a human in Thailand. The patient was in the 1st trimester of pregnancy when she developed scrub typhus. The O. tsutsugamushi strain TA716 was detected from her admission blood sample, and the pregnancy ended in spontaneous abortion. The effects of scrub typhus in pregnant women and the pregnancy outcome are sparsely documented in the published medical literature. Improved clinical recognition and laboratory diagnosis will be es…

Comparative research on epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan.

In order to compare the epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan, we analyzed the current state of tsutsugamushi disease outbreaks and related risk factors. The average prevalence rate of tsutsugamushi disease from 2001 to 2005 in Korea was higher than that in Japan (7.2 and 0.3 per 100,000 population, respectively) (P<0.01). The seasonal distribution in Korea showed that the incidence of tsutsugamushi disease in autumn (94.5% of total cases) was higher than in Japan (38.2%) (P<0.01), while the incidences of outbreaks in other seasons were much hi…

Acute respiratory distress syndrome associated with scrub typhus: diffuse alveolar damage without pulmonary vasculitis.

Pathologic findings of scrub typhus have been characterized by vasculitis of the microvasculature of the involved organ resulting from a direct invasion by Orientia tsutsugamushi. We experienced a case of acute respiratory distress syndrome (ARDS) associated with scrub typhus. The case was proven by eschar and high titer of serum IgM antibody (positive at 1:1280). Open lung biopsy showed diffuse alveolar damage (DAD) in the organizing stage without evidence of vasculitis. Immunofluorescent antibody staining and polymerase chain reaction for O. tsutsugamushi failed to demonstrate the organism i…

Scrub typhus triggers hemophagocytic lymphohistiocytosis in children: metagenomic next-generation sequencing enables rapid diagnosis.

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome. Rapid identification of the underlying trigger is critical for effective clinical management. This study describes the clinical features and diagnostic approach for scrub typhus-associated HLH in children, emphasizing the role of metagenomic next-generation sequencing (mNGS). METHODS: We retrospectively analyzed 12 pediatric patients diagnosed with scrub typhus-associated HLH at Shenzhen Children's Hospital between July 2023 and July 2025. Demographic, clinical, laboratory, and treatment dat…

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…

Eco-serological study of scrub typhus (Orientia tsutsugamushi) among indigenous populations in South India.

Scrub typhus, a vector-borne zoonotic disease, remains a growing public health concern in India, particularly in the Western Ghats. We conducted a sero-prevalence and ectoparasite survey during 2023-2024 among indigenous populations of Kothagiri and Gudalur blocks, Nilgiris district, Tamil Nadu. A total of 240 serum samples from the general population with a mean age of 17 (Range: 5-45) years were screened using IgM and IgG ELISA. In Kothagiri, IgM and IgG positivity rates were 5% and 2.5%, respectively, whereas Gudalur reported 5.83% and 43.33%. Overall, 28% of sera tested positive, with high…

Predictors of mortality in scrub typhus fever: A cross-sectional study from central India.

BACKGROUND OBJECTIVES: Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi , has re-emerged as a major public health challenge in India, especially in rural and resource-constrained areas. Due to its nonspecific presentation and limited diagnostic access, early diagnosis is often missed, leading to potentially fatal complications like acute respiratory distress syndrome (ARDS), renal failure, liver dysfunction, and encephalopathy. This cross-sectional study aimed to identify clinical and laboratory predictors of mortality in scrub typhus patients and emphasize the vital rol…

Клинические и лабораторные исследования в скруб-тихусе, связанные с синдромом Гильен-Барре в Южной Корее.

Скруб тифа является эндемическим заболеванием осеннего сезона, которое происходит в ограниченном числе мест, известных как Треугольник Цутсугамуши. Периферальная нейропатия - это обычное осложнение тифа. Здесь мы столкнулись с несколькими пациентами с восходящим параличом после чистки тифа, у которых был диагностирован синдром Гильен-Барре (ГБС). Мы хотели изучить клинические и лабораторные характеристики пациентов, разработавших GBS после скруба тифа. В период с января 2017 года по декабрь 2021 года пациенты были ретроспективно набраны из шести общенациональных высших учебных заведений в Южно

Совпадение в аннотации оригинала
BACKGROUND AND AIMS: Scrub typhus is an endemic disease in the fall season that occurs in a limited number of places known as the Tsutsugamushi Triangle. Peripheral neuropathy is a common complication of scrub typhus. Herein, we encountered several patients with ascending paralysis after scrub typhus infection, who were diagnosed with Guillain-Barré syndrome…

Predicting Secondary Hemophagocytic Lymphohistiocytosis in Adult Patients with Scrub Typhus and Its Prognostic Significance.

OBJECTIVE: Secondary hemophagocytic lymphohistiocytosis (sHLH) is an increasingly recognized complication in patients with scrub typhus, potentially contributing to substantial mortality despite appropriate antibiotic treatment. This study aims to determine the prevalence and prognosis of sHLH and identify diagnostic factors in adult patients with scrub typhus in North India. METHODS: This prospective cohort study was conducted at PGIMER, Chandigarh, from August 2021 to November 2023. sHLH was defined as an HScore of 200 or above. The diagnostic performance of biomarkers such as ferritin, fib…

Diagnostic Dilemma between Scrub Typhus Meningoencephalitis and Dengue Encephalopathy Resolved! - A Novel Prediction Score.

BACKGROUND: Scrub typhus and dengue, common etiologies of acute encephalitis syndrome, present with similar clinico-laboratory profiles but differ in management protocol. OBJECTIVE: We aimed to devise a score differentiating between scrub typhus meningoencephalitis (STM) and dengue encephalopathy (DE). METHODS: A prospective cohort of 204 children, (aged 6 months to 14 years) presenting with acute encephalitis syndrome in a public teaching hospital in northern India was subjected to standardized workup including serum IgM against Orientia tsutsugamushi and Dengue virus. Clinico-laboratory fe…

Spatiotemporal dynamics and environmental determinants of scrub typhus in Anhui Province, China, 2010-2020.

This study aims to describe the epidemiological characteristics of scrub typhus, detect the spatio-temporal patterns of scrub typhus at county level, and explore the associations between the environmental variables and scrub typhus cases in Anhui Province. Time-series analysis, spatial autocorrelation analysis, and space-time scan statistics were used to explore the characteristics and spatiotemporal patterns of the scrub typhus in Anhui Province. Negative binomial regression analysis was used to explore the association between scrub typhus and environmental variables. A total of 16,568 clinic…

Spatiotemporal epidemiology and risk factors of scrub typhus in Hainan Province, China, 2011-2020.

BACKGROUND: The re-emergence of scrub typhus in the southern provinces of China in recent decades has been validated, thereby attracting the attention of public health authorities. There has been a spatial and temporal expansion of scrub typhus in Hainan Province, but the epidemiological characteristics, environmental drivers, and potential high-risk areas for scrub typhus have not yet been investigated. OBJECTIVE: The aims of this study were to characterize the spatiotemporal epidemiology of scrub typhus, identify dominant environmental risk factors, and map potential risk areas in Hainan Pr…

Varicella-Zoster Virus Reactivation During the Incubation Period for Scrub Typhus: A Case Report.

BACKGROUND Herpes zoster caused by the reactivation of latent varicella-zoster virus is thought to result from the waning of specific cell-mediated immunity. Scrub typhus, an acute infectious disease caused by Orientia tsutsugamushi, affects multiple organs and is characterized by microangiopathies that result in significant vascular leakage and subsequent end-organ injury. Very few cases of reactivation of the varicella-zoster virus following scrub typhus occurrence have been reported. Furthermore, no previous studies have directly investigated whether Orientia tsutsugamushi infection is a po…