J Korean Med Sci.
2019 Oct;34(39):e257. 10.3346/jkms.2019.34.e257.
Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006
- Affiliations
-
- 1Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. hswon1@snu.ac.kr
- 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
- 4Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
- 5Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 6Department of Internal Medicine, Pohang St. Mary's Hospital, Pohang, Korea.
- KMID: 2459426
- DOI: http://doi.org/10.3346/jkms.2019.34.e257
Abstract
- BACKGROUND
Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections.
METHODS
The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described.
RESULTS
One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV.
CONCLUSION
We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
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