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Case Report: Severe sepsis due to imported scrub typhus in a German traveler returning from Vietnam.

Scrub typhus, caused by the obligate intracellular bacterium Orientia (O.) tsutsugamushi, is an under-recognized cause of febrile illness in travelers returning from endemic regions of the Asia-Pacific. We report the case of a 39-year-old woman who presented with high-grade fever, headache, and hepatitis with coagulopathy following travel to Vietnam. Her condition deteriorated rapidly progressing to sepsis. Laboratory investigations revealed hemolysis with mild anemia, thrombocytopenia, as well as markedly elevated liver enzymes and inflammatory markers. Computed tomography demonstrated extens…

A CRISPR-Cas12a-based universal rapid scrub typhus diagnostic method targeting 16S rRNA of Orientia tsutsugamushi.

Scrub typhus is caused by Orientia tsutsugamushi infection and occurs frequently in an area called the Tsutsugamushi Triangle. Currently, there is no vaccine for O. tsutsugamushi, and its infection is treated with antibiotics such as doxycycline. Scrub typhus responds to effective treatment, and early treatment shortens the course of the disease, reduces mortality, and accelerates recovery. Therefore, it is important to rapidly diagnose O. tsutsugamushi infection to ensure successful outcomes. Here, we developed a CRISPR-Cas12a-based diagnostic method targeting the bacterial 16S rRNA to detect…

Severe Scrub Typhus with Acute Kidney Injury: Urine PCR Evidence from an East Coast Malaysian Cluster.

Background: Scrub typhus (ST) is caused by Orientia tsutsugamushi (OT) infection, which is transmitted to humans through the bites of infected chiggers. The clinical presentations range from mild to life-threatening multi-organ dysfunction. This report describes a cluster of ST cases involving five oil palm estate workers in Pekan district, Pahang, Malaysia. Methods: The clinical history, laboratory, and entomological investigation were conducted on the patients, including the index case and four suspected cases in the cluster. Polymerase chain reaction (PCR) tests for OT and genotyping were p…

Severe Scrub Typhus Presenting With Multiorgan Dysfunction and Atypical Features: Two Case Reports From the Maldives.

Scrub typhus, caused by the obligate intracellular bacterium Orientia tsutsugamushi, is an emerging cause of acute febrile illness with a broad clinical spectrum ranging from mild self-limited fever to life-threatening multiorgan dysfunction syndrome (MODS). We report two unusual, clinically severe cases from the Maldives illustrating the diagnostic challenges and systemic involvement characteristic of severe scrub typhus. The first case involved a 42-year-old previously healthy male who presented with fever, progressive respiratory distress, severe hyperglycemia, metabolic acidosis, and acute…

Climate influences scrub typhus occurrence in Vellore, Tamil Nadu, India: analysis of a 15-year dataset.

Climate is one of the major factors determining the prevalence and seasonality of vector borne diseases like scrub typhus (ST). We analyzed, the association of the meteorological factors like temperature, rainfall and humidity with scrub typhus using the 15 years scrub typhus data from a tertiary care hospital in Vellore, South India. Demographic data of permanent residents of Vellore, who had IgM ELISA results for scrub typhus for the time period of May 2005 to April 2020 were included. Meteorological data was correlated with the monthly scrub typhus cases; negative binomial regression model …

Molecular epidemiological study of Scrub Typhus in residence, farm and forest habitats from Yunnan Province, China.

The number of people suffering from scrub typhus, which is not of concern, is increasing year by year, especially in Yunnan Province, China. From June 1, 2021 to August 15, 2022, a total of 505 mammalian samples were collected from farm, forest, and residential habitats with high incidence of scrub typhus in Yunnan, China, for nPCR (nested PCR) and qPCR (quantitative real-time PCR) detection of Orientia tsutsugamushi. A total of 4 orders of murine-like animals, Rodentia (87.52%, n = 442), Insectivora (10.29%, n = 52), Lagomorpha (1.79%, n = 9) and Scandentia (0.40%, n = 2) were trapped. Compar…

A Multi-epitope Subunit Vaccine Identification and Development Against Scrub Typhus (Orientia tsutsugamushi) Using Immunoinformatics Approaches.

Background The pathogen Orientia tsutsugamushi, which causes scrub typhus, is rapidly spreading throughout the tropics. As a measure to improve public health, the development of a vaccine for human use is essential. Scrub typhus is listed as one of the underdiagnosed and underreported febrile infections. This vector-borne zoonotic infection appears as eschar on the patient's skin. Methods Immunoinformatics was employed to predict the multi-epitope subunit vaccine that will activate both B and T cells. The final vaccine includes lipoprotein LprA as an adjuvant at the N-terminus along with B-cel…

Under-diagnosis of vector-borne diseases among individuals suspected of having Scrub Typhus in South Korea.

Due to environmental and ecological changes and suitable habitats, the occurrence of vector-borne diseases is increasing. We investigated the seroprevalence of four major vector-borne pathogens in human patients with febrile illness who were clinically suspected of having Scrub Typhus (ST) caused by Orientia tsutsugamushi. A total of 187 samples (182 patient whole blood and sera samples, including 5 follow-up) were collected. Antibodies to Anaplasma phagocytophilum, Ehrlichia chaffeensis, Borrelia burgdorferi, and Bartonella henselae were tested by using indirect immunofluorescence assays. Mol…

Case report of scrub typhus with bilateral acute sensorineural hearing loss and cerebral salt-wasting disease.

Scrub typhus is a re-emerging and endemic disease in the Asia Pacific region caused by Orientia tsutsugamushi. We present a 65-year-old male from Sri Lanka who presented with fever, bilateral acute sensorineural hearing loss, and confusion. On examination, he was dehydrated. Significant orthostatic hypotension and an eschar were noted. Investigations revealed hyponatraemia with elevated urine sodium, reduced serum osmolality, and normal urine osmolality suggestive of cerebral salt wasting. After initial hydration with 0.9% NaCl, hyponatraemia was corrected with 3% NaCl. Oral doxycycline was pr…

Highly Accurate and Fast Electrochemical Detection of Scrub Typhus DNA via a Nanoflower NiFe-Based Biosensor.

Owing to the lack of specific diagnostic methods, Scrub typhus can sometimes be difficult to diagnose in the Asia-Pacific region. Therefore, an efficient and rapid detection method urgently needs to be developed. Based on competitive single-stranded DNA over modified glassy carbon electrode (GCE), an electrochemical biosensor was established to detect the disease. The nano-flower NiFe layered double hydroxide (NiFe-LDH) modified GCE has a large specific surface area, which supported a large amount of gold nanoparticles, so that a wide linear detection range from 25 fM to 0.5 μM was obtained. T…

Неврологические манифестации "Scrub Typhus": Серия судебных дел из больницы Tertiary Health in Southern East Radasthan.

Scrub tyhus — острая инфекционная болезнь, вызванная рикеттсийским видом Orictia tsutsugamushi. В последние годы в Индии скруб тифа вновь стал опасным для жизни заболеванием, которое проявляется в различных клинических проявлениях: от неконкретного фебрилического заболевания до серьезной многоорганической дисфункции, и неврологические осложнения также широко распространены. Спектр неврологических осложнений варьируется от таких распространенных осложнений, как асептический менингит, менингоэнцефалит и церебеллит, до редких осложнений, таких, как миелит, кровоизлияние в мозг, острый распределен

Совпадение в аннотации оригинала
Scrub typhus is an acute febrile infectious illness caused by rickettsia species Orientia tsutsugamushi. In recent years, scrub typhus has reemerged as a life-threatening disease in India Scrub typhus has diverse clinical manifestations ranging from a nonspecific febrile illness to severe multiorgan dysfunction, and neurological complications are also common…

Diagnostic performance of serological tests to detect antibodies against acute scrub typhus infection in central India.

BACKGROUND: Differentiating scrub typhus from other acute febrile illness is difficult due to non specificity of clinical symptoms and relative absence of eschar in Indian population. The diagnosis thus relies mainly on laboratory tests. Antibody based serological tests are mainstay of scrub typhus diagnosis. Here, we evaluated the diagnostic performance of IgM ELISA, IgM IFA and ICT to detect antibodies against O. tsutsugamushi in acute serum of febrile patients. METHODOLOGY: The serum samples from 600 randomly selected patients suffering from acute undifferentiated fever were tested by all …

The intracellular pathogen Orientia tsutsugamushi responsible for scrub typhus induces lipid droplet formation in mouse fibroblasts.

Mammalian cells store excess fatty acids in the form of triglycerides within lipid droplets. The intracellular bacterium Orientia tsutsugamush is the causative agent of severe human rickettiosis. We found that O. tsutsugamushi infection induces the formation of lipid droplets in mouse L-929 fibroblasts. In infected cells, a parallel increase in the number of lipid droplets and pathogens was observed. Interestingly, the pathogen-infection induced the accumulation of triglycerides even without external supply of fatty acids. These results suggest that O. tsutsugamushi alters lipid metabolism of

Morphological Variations and Anatomical Distribution of Atypical Eschars in Pediatric Scrub Typhus: A Prospective Observational Study.

BACKGROUND: Necrotic flexural eschar is a pathognomonic cutaneous marker of scrub typhus (ST). Relying solely on the classic necrotic flexural eschar can result in missed diagnoses when lesions present atypically. This study evaluated the clinical profile and predictors of atypical eschars (ATEs) in children with ST. METHODS: In this 5-year prospective observational study from South India, children (< 12 years) with serologically confirmed ST (IgM ELISA) were systematically examined for eschars using a standardized whole-body assessment. Eschars were classified as typical eschars (TEs: necrot…

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…

Epidemiological trends and regional risk factors for scrub typhus in Busan, Republic of Korea: 2019-2023.

BACKGROUND: Scrub typhus, an acute disease caused by Orientia tsutsugamushi and transmitted by larval chigger mites, is a representative autumn febrile illness in the Republic of Korea. We examined epidemiological characteristics underlying spatial heterogeneity in Busan Metropolitan City to inform region-specific prevention and control policies. METHODS: We analyzed 1,645 confirmed and suspected scrub typhus cases reported in Busan from 2019 to 2023. Crude incidence rates and age-standardized incidence rates (ASIRs) per 100,000 population were calculated using the 2021 mid-year population. T…

Correction: Cost of illness of scrub typhus in South India - a population-based, mixed-methods study.

[This corrects the article DOI: 10.1371/journal.pntd.0013960.].

A retrospective report on chiggers at a focus of scrub typhus on the China-Vietnam border in Yunnan of southwest China.

IMPORTANCE: Chiggers are the exclusive vector of scrub typhus. Jinping County, located along the China-Vietnam border in southwest China, is a focus of scrub typhus. It is of medical and veterinary importance to study chiggers in this area. OBJECTIVE: The present study made a retrospective analysis aiming to report chiggers on small mammals (hosts) in Jinping County on the China-Vietnam border, Yunnan of southwest China. METHODS: The indexes of chigger infestation and chigger community were routinely calculated. The niche width and overlap were calculated for analyzing chiggers' host selecti…