J Korean Med Sci.  2012 Mar;27(3):231-235. 10.3346/jkms.2012.27.3.231.

Persistence of Orientia tsutsugamushi in Humans

• Chung MH
• Lee JS
• Baek JH
• Kim M
• Kang JS

• KMID: 1792991
• DOI: http://doi.org/10.3346/jkms.2012.27.3.231

Abstract

We investigated the persistence of viable Orientia tsutsugamushi in patients who had recovered from scrub typhus. Blood specimens were available from six patients with scrub typhus who were at 1 to 18 months after the onset of the illness. The EDTA-treated blood specimens were inoculated into ECV304 cells, and cultures were maintained for 7 months. Sequencing of the 56-kDa type-specific antigen gene of O. tsutsugamushi was performed to ascertain the homology of isolates. O. tsutsugamushi was isolated from all six patients, and nucleotide sequences of isolates serially collected from each patient were identical in all five patients in whom nucleotide sequences were compared. One patient relapsed 2 days after completion of antibiotic therapy; two patients complained of weakness for 1 to 2.5 months after the illness; one patient underwent coronary angioplasty 6 months later; and one patient suffered from a transient ischemic attack 8 months later. This finding suggests that O. tsutsugamushi causes chronic latent infection, which may be associated with certain clinical illnesses, preceded by scrub typhus. Antibiotic therapy abates the symptoms of scrub typhus, but does not eradicate O. tsutsugamushi from the human body.

Keyword

Orientia tsutsugamushi; Scrub typhus; Persistence; Recurrence; Atherosclerosis

MeSH Terms

Adult
Aged
Aged, 80 and over
Antigens, Bacterial/genetics
Bacterial Proteins/genetics
Base Sequence
Case-Control Studies
Chronic Disease
Coronary Artery Disease/etiology
DNA, Bacterial/genetics/isolation & purification
Female
Genes, Bacterial
Humans
Ischemic Attack, Transient/etiology
Male
Membrane Proteins/genetics
Middle Aged
Muscle Weakness/etiology
Orientia tsutsugamushi/genetics/immunology/*isolation & purification
Recurrence
Scrub Typhus/complications/drug therapy/*microbiology
Time Factors

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