Infect Chemother.  2009 Dec;41(6):315-322. 10.3947/ic.2009.41.6.315.

Clinical Features and Diagnosis of Scrub Typhus

• Kim DM

• KMID: 2285036
• DOI: http://doi.org/10.3947/ic.2009.41.6.315

Abstract

Scrub typhus is the most common rickettsial disease in Korea. Scrub typhus is an acute febrile illness with characteristic findings such as high fever, rash, headache, and eschar. It is caused by intracellular gram-negative bacteria Orientia tsutsugamushi. Infection occurs when larvae of thrombiculid mite (chiggers) infected with O. tsutsugamushi bite people and suck human tissue fluid. Although scrub typhus runs a mild clinical course and shows a good response to antibiotic therapy, serious complications such as interstitial pneumonia, acute renal failure, meningoencephalitis, gastrointestinal bleeding, and multiple organ failure may develop when diagnosis is delayed and can even lead to death. It is often difficult to diagnose scrub typhus only by clinical features and therefore, more rapid and accurate diagnostic evaluation may be required. This review will focus on clinical feature, and diagnosis of scrub typhus.

Keyword

Scrub typhus; Orientia tsutsugamushi; Clinical feature; Diagnosis

MeSH Terms

Acute Kidney Injury
Bites and Stings
Exanthema
Fever
Gram-Negative Bacteria
Headache
Hemorrhage
Humans
Korea
Larva
Lung Diseases, Interstitial
Meningoencephalitis
Mites
Multiple Organ Failure
Orientia tsutsugamushi
Scrub Typhus

Figure

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  Figure 1 Sites that manifest an eschar in scrub typhus patients. Abbreviations:a, male front; b, male back; c, female front; d, female back. Date source; Kim DM, Won KJ, Park CY, Yu KD, Kim HS, Yang TY, Lee JH, Kim HK, Song HJ, Lee SH, and Shin H. Distribution of eschars on the body of scrub typhus patients : A prospective study. Am J Trop Med Hyg 76(5):806-9, 2007.

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  Figure 2 Changing patterns of median antibody titers with time in scrub typhus patients. Date source; Kim DM,Lee YM, Back JH, Yang TY, Lee JH, Song HJ, Shim SK, Hwang KJ, Park MY. A serosurvey of Orientia tsutsugamushi from patients with scrub typhus. Clin Microbiol Infect. 2010 in press.

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