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Thematische Bibliographien / Typhus / Zeitschriftenartikel

Zeitschriftenartikel zum Thema „Typhus“

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Autor: Grafiati

Veröffentlicht am 4. Juni 2021

Zuletzt aktualisiert am 5. März 2023

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1

Voitl, Julian J. M. „Fallstricke der tropenmedizinischen Nomenklatur am Beispiel „Typhus““. Flugmedizin · Tropenmedizin · Reisemedizin - FTR 30, Nr. 01 (Februar 2023): 20–22. http://dx.doi.org/10.1055/a-1988-0069.

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ZUSAMMENFASSUNGViele infektiologische Diagnosen sind historisch gewachsene, symptombeschreibende Hilfswerkzeuge, die sich oft entgegen modernen, genetisch-taxonomischen Bemühungen zu halten vermögen. Dieser Artikel ist der Versuch einer Reise in die Tiefen der Nomenklaturunterwelt, ohne dabei selbst typhös zu werden. Jeder identifizierte Begriff wurde auf Verwechslungsgefahr oder Mehrfachverwendung untersucht. Eine Vermeidung der Begriffe „Typhus – typhus fever“ oder „Fleckfieber – spotted fever“, sowie manch anderer überholter Termini, wäre anzudenken.

2

Acharya, Suman, Jayant Kumar Yadav, Nischal Khanal, Raju Bhandari und Bikal Ghimire. „Acute Severe Calculous Cholecystitis with Multiorgan Failure Complicated by Scrub Typhus“. Case Reports in Surgery 2019 (24.06.2019): 1–4. http://dx.doi.org/10.1155/2019/7505108.

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Scrub typhus is a febrile illness and can present with manifestations ranging from subclinical symptoms to multiorgan failure and death. Scrub typhus is a rare etiology of acute cholecystitis. A patient presenting with the features of acute cholecystitis who does not respond to standard treatment should be screened for scrub typhus in a typhus endemic region. We report a case of a 70-year-old female with acute severe calculous cholecystitis with multiorgan failure complicated by scrub typhus. She improved remarkably after starting doxycycline for scrub typhus. Scrub typhus should be considered as a trigger in a patient presenting with cholecystitis in a typhus endemic region.

3

Mary, D. Therese. „Scrub Typhus (Chigger – Borne Typhus): A Case of Scrub Typhus with Eschar“. International Journal of Current Microbiology and Applied Sciences 5, Nr. 4 (10.04.2016): 303–5. http://dx.doi.org/10.20546/ijcmas.2016.504.035.

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4

Eraksoy, Haluk. „Rickettsioses: From Epidemic Typhus to Scrub Typhus“. Klimik Dergisi/Klimik Journal 27, Nr. 1 (15.05.2015): 1. http://dx.doi.org/10.5152/kd.2014.01.

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5

Bacellar, F., I. Lencastre und A. R. Filipe. „Is murine typhus re-emerging in Portugal ?“ Eurosurveillance 3, Nr. 2 (01.02.1998): 18–20. http://dx.doi.org/10.2807/esm.03.02.00124-en.

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Murine typhus or endemic typhus is an infectious disease, clinically very similar to epidemic typhus, and caused by Rickettsia typhi(sometimes referred to as R. mooseri). Murine typhus was fairly common in Portugal until the 1940s, when several cases diag

6

Thapa, S., L. B. Sapkota und P. Hamal. „Threat of scrub typhus in post-earthquake Nepal“. Journal of Chitwan Medical College 6, Nr. 4 (20.02.2017): 1–6. http://dx.doi.org/10.3126/jcmc.v6i4.16707.

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Scrub typhus is a potentially fatal zoonotic infection, reported from many parts of Asia including Nepal. There is increasing reports of outbreak of Scrub typhus, after the earthquake hit Nepal on April 25, 2015. The recent outbreak of Scrub typhus posed problems in diagnosis and treatment of the disease. It may be related to poor awareness of the disease or lack of suspicion for Scrub typhus which often presents with clinical features indistinguishable from typhoid fever. Since, various parts of Nepal appeared to be suitable hubs for Scrub typhus, the clinical suspicion of Scrub typhus in the differential diagnosis of fever of unknown origin (FUO) is of utmost importance to prevent mortality and morbidity. This is a prospective study conducted in Chitwan Medical College (CMC), Chitwan, Nepal. This study was carried out over a period of 4 months extending from June 2016 to September 2016. A total of 410 serum samples were collected from all patients visiting CMC, clinically suspected of having Scrub typhus infection. The samples were processed for the detection of IgM antibodies for Scrub typhus by ELISA. Results: A total of 410 samples from patients suspected with Scrub typhus infection were processed which included 200 males and 210 females. Out of total 410 samples tested, 181 (44.1%) were seropositive for Scrub typhus. Seropositivity was highest 25.9% among the age group 11-20 years of age. Females were infected more than males. This study implies the re-emergence of Scrub typhus in different regions of Nepal. Although the disease is endemic in our country, it is grossly underdiagnosed owing to non-specific clinical presentation and lack of diagnostic facilities. It is thus suggested that high index of suspicion should be maintained for cases presenting with febrile illness. Infection with Scrub typhus was found high and this calls for an urgent need to introduce vaccine against Scrub typhus.

7

Konyak, Nyamnyei, Medo M. Kuotsu, Labresai Mog, Sandipa Roy Chowdhury, Prity Ering, Prabin Kumar Majhi und Pranab Kumar Medhi. „Scrub typhus associated acute kidney injury in a 33-year-old male“. International Journal of Advances in Medicine 8, Nr. 9 (21.08.2021): 1427. http://dx.doi.org/10.18203/2349-3933.ijam20213250.

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Scrub typhus or bush typhus is caused by Orientia tsutsugamushi. An eschar at the site of bite is evidentiary of scrub typhus. Increased mortality is seen in cases presenting with acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), pneumonitis, meningitis, myocarditis and multi-organ dysfunction. Renal impairment in scrub typhus should be identified and management initiated early to prevent the progress of the damage. Scrub typhus if left undiagnosed and untreated results in high morbidity and mortality. Here we report a case of a 33-year-old male with AKI following scrub typhus fever. In our case early diagnosis and management led the patient to recovery.

8

Xin, Hualei, Peng Fu, Junling Sun, Shengjie Lai, Wenbiao Hu, Archie C. A. Clements, Jianping Sun et al. „Risk mapping of scrub typhus infections in Qingdao city, China“. PLOS Neglected Tropical Diseases 14, Nr. 12 (02.12.2020): e0008757. http://dx.doi.org/10.1371/journal.pntd.0008757.

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Background The emergence and re-emergence of scrub typhus has been reported in the past decade in many global regions. In this study, we aim to identify potential scrub typhus infection risk zones with high spatial resolution in Qingdao city, in which scrub typhus is endemic, to guide local prevention and control strategies. Methodology/Principal findings Scrub typhus cases in Qingdao city during 2006–2018 were retrieved from the Chinese National Infectious Diseases Reporting System. We divided Qingdao city into 1,101 gridded squares and classified them into two categories: areas with and without recorded scrub typhus cases. A boosted regression tree model was used to explore environmental and socioeconomic covariates associated with scrub typhus occurrence and predict the risk of scrub typhus infection across the whole area of Qingdao city. A total of 989 scrub typhus cases were reported in Qingdao from 2006–2018, with most cases located in rural and suburban areas. The predicted risk map generated by the boosted regression tree models indicated that the highest infection risk areas were mainly concentrated in the mid-east and northeast regions of Qingdao, with gross domestic product (20.9%±1.8% standard error) and annual cumulative precipitation (20.3%±1.1%) contributing the most to the variation in the models. By using a threshold environmental suitability value of 0.26, we identified 757 squares (68.7% of the total) with a favourable environment for scrub typhus infection; 66.2% (501/757) of the squares had not yet recorded cases. It is estimated that 6.32 million people (72.5% of the total population) reside in areas with a high risk of scrub typhus infection. Conclusions/Significance Many locations in Qingdao city with no recorded scrub typhus cases were identified as being at risk for scrub typhus occurrence. In these at-risk areas, awareness and capacity for case diagnosis and treatment should be enhanced in the local medical service institutes.

9

Das, ShyamalKumar, und Souvik Dubey. „Scrub typhus“. Neurology India 63, Nr. 2 (2015): 130. http://dx.doi.org/10.4103/0028-3886.156270.

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10

Kanjiya, K., U. Agrawal und A. Sunavala. „Disseminated typhus“. International Journal of Infectious Diseases 101 (Dezember 2020): 141. http://dx.doi.org/10.1016/j.ijid.2020.09.382.

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11

Bhattacharyya, Prithwis, und AmyG Rapsang. „Scrub typhus“. Indian Journal of Anaesthesia 57, Nr. 2 (2013): 127. http://dx.doi.org/10.4103/0019-5049.111835.

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12

Dubey, Sneha R. „Scrub Typhus“. International Journal of Nursing Education and Research 7, Nr. 2 (2019): 287. http://dx.doi.org/10.5958/2454-2660.2019.00066.8.

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13

James, J., und N. K. Thulaseedharan. „Scrub typhus“. QJM 109, Nr. 8 (19.05.2016): 569. http://dx.doi.org/10.1093/qjmed/hcw075.

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14

LERDTHUSNEE, K., B. KHUNTIRAT, W. LEEPITAKRAT, P. TANSKUL, T. MONKANNA, N. KHLAIMANEE, I. INLAO et al. „Scrub Typhus“. Annals of the New York Academy of Sciences 990, Nr. 1 (Juni 2003): 25–35. http://dx.doi.org/10.1111/j.1749-6632.2003.tb07333.x.

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15

Pau, Wilson Shu Cheng, und Kah Kee Tan. „Scrub Typhus“. Pediatric Infectious Disease Journal 27, Nr. 6 (Juni 2008): 569–70. http://dx.doi.org/10.1097/inf.0b013e318168db08.

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16

Kolyvanos Naumann, Urania, Käser und Vetter. „Typhus abdominalis“. Praxis 93, Nr. 18 (01.04.2004): 747–52. http://dx.doi.org/10.1024/0369-8394.93.18.747.

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17

Bechah, Yassina, Christian Capo, Jean-Louis Mege und Didier Raoult. „Epidemic typhus“. Lancet Infectious Diseases 8, Nr. 7 (Juli 2008): 417–26. http://dx.doi.org/10.1016/s1473-3099(08)70150-6.

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18

Lee, Chang-Seop, und Jeong-Hwan Hwang. „Scrub Typhus“. New England Journal of Medicine 373, Nr. 25 (17.12.2015): 2455. http://dx.doi.org/10.1056/nejmicm1503639.

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19

ESPERANZA, LOWELLA, DOUGLAS A. HOLT, JOHN T. SINNOTT, MARGARITA R. CANCIO, ELIZABETH A. BRADLEY und MARK DEUTSCH. „Murine Typhus“. Southern Medical Journal 85, Nr. 7 (Juli 1992): 754–55. http://dx.doi.org/10.1097/00007611-199207000-00020.

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20

Nallasamy, Karthi, und ML Keshavamurthy. „Scrub typhus“. Journal of Pediatric Critical Care 4, Nr. 3 (2017): 54. http://dx.doi.org/10.21304/2017.0403.00194.

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21

Suputtamongkol, Y. „Scrub Typhus“. International Journal of Infectious Diseases 12 (Dezember 2008): e42-e43. http://dx.doi.org/10.1016/j.ijid.2008.05.156.

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22

Jessen, Andre. „Der Typhus“. Heilberufe 69, Nr. 9 (28.08.2017): 82. http://dx.doi.org/10.1007/s00058-017-3009-y.

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23

Puvačić, Zlatko, Edina Bešlagić, Šukrija Zvizdić, Sandra Puvačić, Jelena Ravlija und Sadeta Hamzić. „Eradication of Typhus Exanthematicus in Bosnia and Herzegovina“. Bosnian Journal of Basic Medical Sciences 6, Nr. 1 (20.02.2006): 71–74. http://dx.doi.org/10.17305/bjbms.2006.3215.

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Typhus exanthematicus in Bosnia and Herzegovina held in endemic areas from which especially quickly began spread after 1945. That year, in 1945, one hundred epidemics of typhus fever appeared, with the highest incidence rate in Europe of 215.04 per 1,000. Directions of unique program in the world were to eradicate lice of the body, but also establish monitoring of the recidivism, Brill-Zinsser disease. Since 1971, typhus exanthematicus (classical typhus) hasn't appeared in Bosnia and Herzegovina, so epidemic typhus can considered as an eradicated communicable disease.

24

Madhup, S. K., R. Shrestha, N. Katuwal, S. R. Magar, S. Shrestha, S. Bhandari und D. Tamrakar. „Seroprevalence of Scrub Typhus in Patients Attending Dhulikhel Hospital, Kavre“. Kathmandu University Medical Journal 19, Nr. 4 (31.12.2021): 494–98. http://dx.doi.org/10.3126/kumj.v19i4.49784.

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Background Scrub typhus is a largely ignored tropical disease and a leading cause of undifferentiated febrile illness. It is caused by Orientia tsutsugamushi. Scrub Typhus is frequently observed in South Asian countries. However, clear epidemiological information of this disease is lacking in case of Nepal. Nepal has shown steady increase in cases of Scrub Typhus since 2015. The epidemiological data related to this disease would support the decision making and surveillance design for early outbreak detection and immediate responses including prevention and treatment of scrub typhus in Nepal. Objective To understand prevalence of Scrub Typhus in subjects who had visited outpatient department at Dhulikhel Hospital. Method In this study, we have studied antibody test data (n=784) for Scrub Typhus from 2019 to 2021. The tests were performed on serum samples of patients who had visited OPD at Dhulikhel Hospital with fever lasting more than 5 days. The kit used in analysis was Scrub Typhus Detect™ IgM ELISA Kit from InBios International. Result Out of the total subjects (n=784), 133 were positive (16.9%) for IgM antibody of Scrub Typhus. The positivity in female (18.6%) was higher than the male subjects (15.3%). The positivity rate was variable among the different age groups, with highest positivity for age group 0-14 years (25%). The seasonal variation was also observed among the seropositive cases. Conclusion Scrub Typhus being a neglected tropical disease has high prevalence. It can be postulated that female subjects and subjects of age group 0-14 years are vulnerable to the infection with Scrub Typhus. There is need to increase the surveillance of Scrub Typhus to add the knowledge for diagnosis and treatment.

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Kumar, Amsa Palanikumar Goutham, Subramaniam Suresh Kanna und Dinesh Babu. „SCRUB TYPHUS PRESENTING AS ACUTE PANCREATITIS: A RARE CASE“. Gomal Journal of Medical Sciences 19, Nr. 4 (31.12.2021): 157–58. http://dx.doi.org/10.46903/gjms.19.04.1039.

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Scrub typhus is an insect-borne disease caused by Orientia sutsugamushi which may cause disseminated vasculitis and perivascular inflammatory lesions resulting in significant vascular leakage and cause end organ damage. Scrub typhus can lead to severe complications such as acute respiratory distress syndrome (ARDS), myocarditis, hepatitis and meningoencephalitis. Some unusual presentations of scrub typhus are peritonitis, gastric ulceration, duodenal ulcer perforation and acalculous cholecystitis. But acute pancreatitis is a relatively rare complication of scrub typhus. Here we report a rare case of scrub typhus in the form of acute pancreatitis.

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YANG, L. P., J. LIU, X. J. WANG, W. MA, C. X. JIA und B. F. JIANG. „Effects of meteorological factors on scrub typhus in a temperate region of China“. Epidemiology and Infection 142, Nr. 10 (02.01.2014): 2217–26. http://dx.doi.org/10.1017/s0950268813003208.

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SUMMARYScrub typhus is emerging and re-emerging in many areas: climate change may affect its spread. To explore the effects of meteorological factors on scrub typhus, monthly cases of scrub typhus from January 2006 to December 2012 in the Laiwu district of temperate northern China were analysed. We examined the correlations between scrub typhus and meteorological factors (and their delayed effects). We built a time-series adjusted negative binomial model to reflect the relationships between climate variables and scrub typhus cases. The key determinants of scrub typhus transmission were temperature, relative humidity and precipitation. Each 1°C increase in monthly average temperature in the previous 3 months, each 1% increase in monthly relative humidity in the previous 2 months and each 1 mm increase in monthly precipitation in the previous 3 months induced 15·4%, 12·6% and 0·7% increases in the monthly number of cases, respectively. In conclusion, scrub typhus is affected by climate change in temperate regions.

27

Mukherjee, Reema. „Is Delhi an Emerging Scrub Typhus Hotspot? An Entomological and Zoonotic Exploration of a Scrub Typhus Outbreak“. Journal of Communicable Diseases 54, Nr. 1 (31.03.2022): 100–106. http://dx.doi.org/10.24321/0019.5138.202256.

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Background: Scrub typhus is an emerging public health challenge in India with increasing evidence of its activity being reported from all over the country. An outbreak of scrub typhus was reported from an area of South West Delhi, India hitherto not known for scrub typhus activity which prompted this zoonotic and entomological investigation.Methods: Zoonotic and entomological investigations were undertaken in five residential areas of South West Delhi, India located in the vicinity of the reporting hospital to determine the rodent hosts, vector mite diversity, and rickettsial activity in rodents. The rickettsial activity was ascertained using Weil-Felix test.Results: Palam area of Delhi, India is a hotspot of scrub typhus with evidence of tick and endemic typhus activity as well. This study reports the presence of known vectors of scrub typhus viz. Leptotrombidium deliense and Schoengastiella ligula, besides enriching the database of mite fauna of Delhi with an addition of a total of five new records, three of Leptotrombidium - vietzi, bhattipadense, fulmentum, and two records of Ascoschoengastia indica and Walchia lupella.Conclusion: The study reports Delhi as a scrub typhus hotspot. In Delhi, Palam was the most affected and had the highest number of cases and deaths, presence of the vectors of scrub typhus and evidence of tick and endemic typhus activity amongst rodents. The mite database of Delhi has been updated with the addition of five new trombiculid mite records.

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Kim, Yong-Chan, Soriul Kim, Hee-Kwon Kim, Yi Lee, Chol Shin, Chang-Seop Lee und Byung-Hoon Jeong. „Genome-Wide Association Study Identifies Eight Novel Loci for Susceptibility of Scrub Typhus and Highlights Immune-Related Signaling Pathways in Its Pathogenesis“. Cells 10, Nr. 3 (05.03.2021): 570. http://dx.doi.org/10.3390/cells10030570.

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Scrub typhus is a fatal zoonotic disease caused by Orientia tsutsugamushi. This disease is accompanied by systemic vasculitis, lymphadenopathy, headache, myalgia, and eschar. In recent studies, a novel strain that is resistant to current medical treatment was identified in Thailand. Thus, the development of new specific drugs for scrub typhus is needed. However, the exact molecular mechanism governing the progression of scrub typhus has not been fully elucidated. To understand disease-related genetic factors and mechanisms associated with the progression of scrub typhus, we performed a genome-wide association study (GWAS) in scrub typhus-infected patients and found a scrub typhus-related signaling pathway by molecular interaction search tool (MIST) and PANTHER. We identified eight potent scrub typhus-related single nucleotide polymorphisms (SNPs) located on the PRMT6, PLGLB2, DTWD2, BATF, JDP2, ONECUT1, WDR72, KLK, MAP3K7, and TGFBR2 genes using a GWAS. We also identified 224 genes by analyzing protein-protein interactions among candidate genes of scrub typhus and identified 15 signaling pathways associated with over 10 genes by classifying these genes according to signaling pathways. The signaling pathway with the largest number of associated genes was the gonadotropin-releasing hormone receptor pathway, followed by the TGF-beta signaling pathway and the apoptosis signaling pathway. To the best of our knowledge, this report describes the first GWAS in scrub typhus.

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Zheng, Canjun, Dong Jiang, Fangyu Ding, Jingying Fu und Mengmeng Hao. „Spatiotemporal Patterns and Risk Factors for Scrub Typhus From 2007 to 2017 in Southern China“. Clinical Infectious Diseases 69, Nr. 7 (10.12.2018): 1205–11. http://dx.doi.org/10.1093/cid/ciy1050.

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Abstract Background Substantial outbreaks of scrub typhus, coupled with the discovery of this vector-borne disease in new areas, suggest that the disease remains remarkably neglected. The objectives of this study were to map the contemporary and potential transmission risk zones of the disease and to provide novel insights into the health burden imposed by scrub typhus in southern China. Methods Based on the assembled data sets of annual scrub typhus cases and maps of environmental and socioeconomic correlates, a boosted regression tree modeling procedure was used to identify the environmental niche of scrub typhus and to predict the potential infection zones of the disease. Additionally, we estimated the population living in the potential scrub typhus infection areas in southern China. Results Spatiotemporal patterns of the annual scrub typhus cases in southern China between 2007 and 2017 reveal a tremendous, wide spread of scrub typhus. Temperature, relative humidity, elevation, and the normalized difference vegetation index are the main factors that influence the spread of scrub typhus. In southern China, the predicted highest transmission risk areas of scrub typhus are mainly concentrated in several regions, such as Yunnan, Guangxi, Guangdong, Hainan, and Fujian. We estimated that 162 684 million people inhabit the potential infection risk zones in southern China. Conclusions Our results provide a better understanding of the environmental and socioeconomic factors driving scrub typhus spread, and estimate the potential infection risk zones beyond the disease’s current, limited geographical extent, which enhances our capacity to target biosurveillance and help public health authorities develop disease control strategies.

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Pokhrel, Anil, Binod Rayamajhee, Saroj Khadka, Sandeep Thapa, Samjhana Kapali, Sher Bahadur Pun, Megha Raj Banjara, Prakash Joshi, Binod Lekhak und Komal Raj Rijal. „Seroprevalence and Clinical Features of Scrub Typhus among Febrile Patients Attending a Referral Hospital in Kathmandu, Nepal“. Tropical Medicine and Infectious Disease 6, Nr. 2 (13.05.2021): 78. http://dx.doi.org/10.3390/tropicalmed6020078.

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(1) Background: Scrub typhus (ST) is endemic to Nepal. It is often underdiagnosed and misdiagnosed due to non-specific clinical presentation coupled with limited microbiological facilities, leading to adverse clinical outcomes. This study aimed to assess the seroprevalence of scrub typhus in febrile patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH), Nepal, from August 2018 to April 2019. (2) Materials and Method: Blood/serum samples and clinical and demographic data of adult febrile patients (≥19 years) who attended or were referred to the hospital were collected after obtaining written informed consent from the participants excluding immunocompromised individuals. Collected blood/serum samples were subjected to hematological, biochemical, and serological tests. A serological test for scrub typhus was performed using the ImmuneMed scrub typhus rapid diagnostic test kit. Data generated were analyzed using SPSS software version 24.0. (3) Results: Amongst the 2070 febrile patients, 462 (22.3%) were seropositive to at least one etiological agent of febrile illnesses (scrub typhus: 253 cases, dengue: 101 cases, leptospirosis: 9, brucellosis: 52, malaria: 9 and kala-azar: 20 cases). Scrub typhus accounted for 12.2% (n = 253) of total febrile illnesses followed by dengue (4.9%, n = 101). Mixed seropositivity of scrub typhus with dengue, brucellosis, and typhoid was found in 12 (0.6%), 9 (0.4%), and 5 (0.2%) cases, respectively. Among 253 scrub typhus patients, 53.4% were female. Among the 154 patients, the most common symptoms were fever (100%), headache (79.2%), sweating (70.1%), breathing difficulty (51.3%), redness of the eye (43.5%), and pathognomonic eschar was observed in 9.1% patients. Fifty percent of scrub typhus patients had low platelet count and >30% of patients had an elevated level of liver enzymes (such as serum glutamic oxaloacetic transaminase (SGPT) and serum glutamic pyruvic transaminase (SGOT). (4) Conclusion: Scrub typhus is a considerable cause of febrile illness in Nepal. Females apparently have a higher chance of acquiring scrub typhus. ST presents nonspecific clinical presentation. The diagnostic dilemma of typhus patients can be minimized by the early monitoring of ST-associated symptoms. The country’s health system needs to be strengthened for early outbreak detection, and immediate response actions against scrub typhus to control the future outbreak of ST.

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Shetty, Vishranth N., Gurukanth Rao und Jayaprakash B. „An atypical presentation of scrub typhus“. International Journal of Advances in Medicine 9, Nr. 10 (23.09.2022): 1069. http://dx.doi.org/10.18203/2349-3933.ijam20222408.

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Scrub typhus is caused by Orientia tsutsugamushi, characterised by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillain-Barre syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article shows a case report of neurological manifestations of scrub typhus.

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Gupta, Samiksha, Sahil Grover, Monica Gupta und Daljinderjit Kaur. „Cerebellitis as a rare manifestation of scrub typhus fever“. BMJ Case Reports 13, Nr. 5 (Mai 2020): e233993. http://dx.doi.org/10.1136/bcr-2019-233993.

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Scrub typhus is a mite-borne rickettsial disease caused by Orientia tsutsugamushi, a gram-negative coccobacilli transmitted through the bite of chigger mite. Scrub typhus has diverse clinical manifestations, often presenting either as a simple febrile illness or as a complicated multi-organ dysfunction. Neurological complications in scrub typhus are diverse but their exact incidence is unknown. Cerebellitis is another rare neurological manifestation associated with scrub typhus. Here, we report the case of a 26-year-old woman with serologically confirmed scrub typhus presenting with fever and gross cerebellar dysfunction. MRI was normal. She was managed with antimicrobials and made an uneventful recovery.

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Basra, Gurjot, Megan A. Berman und Lucas S. Blanton. „Murine Typhus: An Important Consideration for the Nonspecific Febrile Illness“. Case Reports in Medicine 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/134601.

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Murine typhus is a widely distributed flea-borne infection caused byRickettsia typhi. Symptoms of murine typhus are nonspecific and mimic a variety of other infectious diseases. We herein report a case of murine typhus in an area where the broad use of DDT in the mid-20th century has now made it a rare disease. The patient described presented with headache, fever, and a faint macular rash. Initial laboratory studies revealed a slight transaminase elevation. Further questioning revealed exposure to opossums, prompting the consideration of murine typhus as a diagnosis. Although typhus group antibodies were not present during the patient’s acute illness, empiric therapy with doxycycline was initiated, and the patient defervesced. One month after convalescence, the patient returned to clinic with serum that contained typhus group antibodies with an IgG titer of 1 : 1024. Murine typhus is an important consideration during the workup of a patient with a nonspecific febrile illness. Exposure to reservoir hosts and the flea vector place humans at risk for this disease. Clinician recognition of this entity is required for diagnosis and effective therapy.

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Matlani, Monika, Supriya Maheshwari, Neha Dubey, Shyam S. Mina und Vinita Dogra. „Clinical profile and seroepidemiology of scrub typhus and its concurrent infections associated with other tropical fevers: a two-year study from a tertiary care centre in North India“. International Journal Of Community Medicine And Public Health 7, Nr. 11 (26.10.2020): 4440. http://dx.doi.org/10.18203/2394-6040.ijcmph20204742.

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Background: The study showed epidemiological aspects, clinical profile and laboratory features of patients presenting with scrub typhus alone and scrub typhus along with concurrent infections namely typhoid, malaria, leptospira, chikungunya and dengue.Methods: A total of 383 suspected cases of Scrub typhus were tested by IgM ELISA from January 2017 to October 2018. Appropriates tests were performed to determine the coinfections of scrub typhus with dengue, chikungunya, malaria, leptospirosis and typhoid fever.Results: Of the 383 samples received, 68 were positive for scrub typhus. Commonest clinical manifestations were fever, shortness of breath, myalgia, headache and jaundice. Maximum number of co infection cases were observed along with dengue.Conclusions: With the rapidly changing epidemiology of scrub typhus, it is very important to become familiar with its clinical presentation when presenting alone and as a concurrent infection with other acute febrile infections.

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Singh, Shweta, Nikesh Sinha, Manoj Kumar und Shashank Nand Tiwari. „An Outbreak Study of Scrub Typhus in Latehar District of Jharkhand“. International Journal of Current Microbiology and Applied Sciences 11, Nr. 2 (10.02.2022): 270–74. http://dx.doi.org/10.20546/ijcmas.2022.1102.030.

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Background and Objectives: Scrub typhus, a zoonotic disease has become a public health problem in many parts of world. It is an arthropod borne gram-negative obligate intracellular bacillus Orientia tsutsugamushi. Aim & objective: We reported in this study a recent outbreak of scrub typhus from Barwadih block of Latehar district, of Jharkhand. Materials and Methods: Samples of clinically suspected cases of scrub typhus (collected by both active and passive surveillance), were tested by IgM ELISA and also Real Time PCR in the Department of Microbiology, RIMS, Ranchi. Results: During the study period, a total of 67 samples from clinically suspected cases of scrub typhus were tested, out of which 16 samples were positive. Conclusion: The increase in scrub typhus infection, prompts us for a better prevention and management of the disease, so as to combat the complications caused by scrub typhus.

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Qian, Li, Yong Wang, Xianyu Wei, Ping Liu, Ricardo J. Soares Magalhaes, Quan Qian, Hong Peng et al. „Epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province during 2012–2020“. PLOS Neglected Tropical Diseases 16, Nr. 9 (29.09.2022): e0010278. http://dx.doi.org/10.1371/journal.pntd.0010278.

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Background Scrub typhus has become a serious public health concern in the Asia-Pacific region including China. There were new natural foci continuously recognized and dramatically increased reported cases in mainland China. However, the epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province have yet to be investigated. Objective This study proposes to explore demographic characteristics and spatiotemporal dynamics of scrub typhus cases in Fujian province, and to detect high-risk regions between January 2012 and December 2020 at county/district scale and thereby help in devising public health strategies to improve scrub typhus prevention and control measures. Method Monthly cases of scrub typhus reported at the county level in Fujian province during 2012–2020 were collected from the National Notifiable Disease Surveillance System. Time-series analyses, spatial autocorrelation analyses and space-time scan statistics were applied to identify and visualize the spatiotemporal patterns of scrub typhus cases in Fujian province. The demographic differences of scrub typhus cases from high-risk and low-risk counties in Fujian province were also compared. Results A total of 11,859 scrub typhus cases reported in 87 counties from Fujian province were analyzed and the incidence showed an increasing trend from 2012 (2.31 per 100,000) to 2020 (3.20 per 100,000) with a peak in 2018 (4.59 per 100,000). There existed two seasonal peaks in June-July and September-October every year in Fujian province. A significant positive spatial autocorrelation of scrub typhus incidence in Fujian province was observed with Moran’s I values ranging from 0.258 to 0.471 (P<0.001). Several distinct spatiotemporal clusters mainly concentrated in north and southern parts of Fujian province. Compared to low-risk regions, a greater proportion of cases were female, farmer, and older residents in high-risk counties. Conclusions These results demonstrate a clear spatiotemporal heterogeneity of scrub typhus cases in Fujian province, and provide the evidence in directing future researches on risk factors and effectively assist local health authorities in the refinement of public health interventions against scrub typhus transmission in the high risk regions.

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Kelamane, Santosha Kelamane, Cheruku Mispah und Sri Sandhya K. „A study on serodiagnosis of scrub typhus in a Teaching Hospital of South India“. PERSPECTIVES IN MEDICAL RESEARCH 9, Nr. 2 (15.10.2021): 10–14. http://dx.doi.org/10.47799/pimr.0902.03.

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Background: crub typhus is caused by Orientia tsutsugamushi (rickettsial disease) commonly transmitted by the bite of larval chiggers of trombiculid mites. It has been one of the important causes of febrile illness, especially in south India. The clinical diagnosis is difficult owing to the non-specific presentation. We in the current study tried to evaluate the serodiagnosis of scrub typhus with the Weil Felix test and IgM ELISA. Methods: This study was conducted in the Department of Microbiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. All the sera samples were subjected to the Weil Felix test using Proteus OX2, OX19, OX-K strain agglutination test, and subsequently, Scrub typhus IgM ELISA test. Results: All the samples were subjected to the Weil Felix test n=4(6.06%) were positive for scrub typhus (OXK antigen) n=11(16.67%) were positive for the spotted group of fever (OX2 antigen) and n=10 (15.15%) were positive of typhus group (OX19 antigen). N=5 sera samples were positive for more than one type of antigens. All the n=66 serum samples were subjected to IgM ELISA for scrub typhus. Out of n=66, only two serum samples (3.03%) were positive by IgM ELISA. Conclusion: Scrub typhus is emerging as an important public health issue. It is one of the important causes of acute febrile illness. Although it is difficult to distinguish scrub typhus based on the clinical symptoms alone a simple test such as Weil Felix was found to be promising in the diagnosis of scrub typhus. ELISA IgM test may be performed additionally in laboratories with adequate facilities. Hence for clinicians, any case with a fever of unknown origin should arouse suspicion of scrub typhus

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SV, Padmavathi Devi, Aruna M, Anil CV Kumar, Hari Krishna Reddy, Sangeetha BL und V. Siva Kumar. „Acute pancreatitis associated with scrub typhus“. Tropical Doctor 47, Nr. 1 (20.07.2016): 65–67. http://dx.doi.org/10.1177/0049475516657759.

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Scrub typhus, or tsutsugamushi fever, is a zoonosis of rural Asia and the western Pacific islands. The causative organism, Orientia (formerly Rickettsia) tsutsugamushi, is transmitted to humans by the bite of a larval Leptotrombidium mite (chigger). Scrub typhus may have gastrointestinal presentations, such as acute acalculous cholecystitis, duodenal ulcer perforation, peritonitis and gastric ulceration. Acute pancreatitis with scrub typhus has been reported rarely. We report a patient of scrub typhus complicated by acute pancreatitis and acute kidney injury.

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Blacksell, Stuart D., Matthew T. Robinson, Paul N. Newton und Nicholas P. J. Day. „Laboratory-acquired Scrub Typhus and Murine Typhus Infections: The Argument for a Risk-based Approach to Biosafety Requirements for Orientia tsutsugamushi and Rickettsia typhi Laboratory Activities“. Clinical Infectious Diseases 68, Nr. 8 (10.08.2018): 1413–19. http://dx.doi.org/10.1093/cid/ciy675.

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The highest-risk activities for scrub/murine typhus laboratory-acquired infections were working with infectious laboratory animals. Eight scrub typhus deaths occurred during the preantibiotic era. Risk-based biosafety approaches would improve efficiencies of in vitro/in vivo growth of scrub/murine typhus.

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Patwardhan, Bhalachandra, Ritu Chaudhary und Rajendra Dutt Mathur. „A study of scrub meningoencephalitis and keeping it as a common differential diagnosis“. International Journal of Research in Medical Sciences 10, Nr. 6 (27.05.2022): 1309. http://dx.doi.org/10.18203/2320-6012.ijrms20221487.

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Background: Scrub typhus is caused by the organism Orientia tsutsugamushi, transmitted by trombiculid mites. Meningoencephalitis as a cause of mortality in cases of scrub typhus is becoming a common entity now. Aims and objectives were to study the incidence of meningoencephalitis in scrub typhus cases admitted to our hospital and stress the importance of keeping it as a common differential diagnosis.Methods: A descriptive observational study of 39 diagnosed cases of scrub typhus admitted to our hospital for 6 months duration (May 2018 to October 2018) was conducted. Data concerning the cases were recorded and analyzed using appropriate statistics.Results: Out of 39 cases admitted, 8 patients were diagnosed as having meningoencephalitis. Patients with meningoencephalitis had severe thrombocytopenia when compared to those without any central nervous system (CNS) symptoms. All patients responded well to doxycycline therapy with no mortality amongst cases under study.Conclusions: There have been numerous outbreaks of scrub typhus in our state of Rajasthan, especially in the Hadoti region. And in recent years, scrub typhus has been an important contributor to the newer class of emerging infections causing mortality in India. Meningoencephalitis although rare forms a major part of the complications of scrub typhus.

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Chu, Kuo-An, Weishan Chen, Chung Y. Hsu, Yao-Min Hung und James Cheng-Chung Wei. „Association of Scrub Typhus With the Risk of Autoimmune Diseases: A Population-Based Cohort Study“. American Journal of Epidemiology 188, Nr. 7 (27.03.2019): 1311–18. http://dx.doi.org/10.1093/aje/kwz074.

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Abstract Infection plays a major role in the development of autoimmune diseases. In this study, we investigated the relationship between scrub typhus and systemic autoimmune diseases. We enrolled 6,928 hospitalized patients with scrub typhus between 2000 and 2012 from the Taiwan National Health Insurance Research Database, and we compared them with 27,712 selected inpatients who had never been diagnosed with scrub typhus (1:4 ratio, matched by age, sex, and index year) in relation to the risk of developing autoimmune diseases. Cox proportional hazards regression analysis was used to analyze the risk of autoimmune diseases by sex, age, and comorbidities, with hazard ratios and 95% confidence intervals. The adjusted hazard ratio for autoimmune diseases for the scrub typhus group was 2.4 (95% confidence interval: 1.66, 3.48, P < 0.0001) compared with the control group. Subgroup analysis showed that women aged <40 years had a significant higher risk of autoimmune diseases. The risk was significantly higher within 3 years after scrub typhus infection. In conclusion, a higher risk of autoimmune diseases was found among the scrub typhus group, especially for female patients, those aged <40 years, and within the first 3 years after getting scrub typhus.

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Mondal, Tapati, Abhik Sarkar, Julius Rahaman und Subhayan Das Gupta. „A study of scrub typhus in a medical college hospital in West Bengal, India“. Biomedicine 42, Nr. 5 (14.11.2022): 1091–93. http://dx.doi.org/10.51248/.v42i5.1942.

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Introduction and Aim: Scrub typhus is one of the leading causes of acute unexplained fever in children. The objective of this study was to determine the serological evidence of scrub typhus and associated clinical features in febrile children. Materials and Methods: This retrospective observational study was performed for a duration of 21 months. Children aged below 12 years, admitted with unexplained fever and other clinical features suggestive of scrub typhus and tested for IgM against scrub typhus were included in our study. A detailed history, clinical profile and sero-prevalence of the children were analysed from record files. Results: Four hundred and seventy one clinically suspected patients of below 12 years were tested for scrub typhus. Out of 471, 172 children were scrub typhus positive. Maximum number of positive cases were detected between the month of August and November. Fever was present in all patients. Nausea and vomiting, abdominal pain, cough, hepatomegaly, splenomegaly, lymphadenopathy, rash, convulsion and jaundice were other presenting clinical features. Eschar was observed only in 2.91% cases. Conclusion: Scrub typhus is to be suspected in every children present with unexplained fever. Early diagnosis and early initiation of specific therapy is crucial for favourable outcome.

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Newton, P. N. „Different Clinical Expression of Murine Typhus and Scrub Typhus“. International Journal of Infectious Diseases 12 (Dezember 2008): e43. http://dx.doi.org/10.1016/j.ijid.2008.05.1244.

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Richards, Allen L., und Ju Jiang. „Scrub Typhus: Historic Perspective and Current Status of the Worldwide Presence of Orientia Species“. Tropical Medicine and Infectious Disease 5, Nr. 2 (01.04.2020): 49. http://dx.doi.org/10.3390/tropicalmed5020049.

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Scrub typhus and its etiological agents, Orientia species, have been around for a very long time. Historical reference to the rickettsial disease scrub typhus was first described in China (313 AD) by Hong Ge in a clinical manual (Zhouhofang) and in Japan (1810 AD) when Hakuju Hashimoto described tsutsuga, a noxious harmful disease in the Niigata prefecture. Other clinicians and scientists in Indonesia, Philippines, Taiwan, Australia, Vietnam, Malaysia, and India reported on diseases most likely to have been scrub typhus in the early 1900s. All of these initial reports about scrub typhus were from an area later designated as the Tsutsugamushi Triangle—an area encompassing Pakistan to the northwest, Japan to the northeast and northern Australia to the south. It was not until the 21st century that endemic scrub typhus occurring outside of the Tsutsugamushi Triangle was considered acceptable. This report describes the early history of scrub typhus, its distribution in and outside the Tsutsugamushi Triangle, and current knowledge of the causative agents, Orientia species.

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Elangovan, Bharathi, und Rajesh N. T. „Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children“. International Journal of Contemporary Pediatrics 6, Nr. 3 (30.04.2019): 1223. http://dx.doi.org/10.18203/2349-3291.ijcp20192016.

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Background: Objective of study was to compare the clinical features and laboratory parameters at admission and differentiate severe dengue from scrub typhus in children.Methods: Retrospective analysis of case records and comparison of clinical and laboratory parameters at admission of all children with a diagnosis of severe dengue and scrub typhus was done.Results: A total of 72 children were included (severe dengue =40; scrub typhus =32) during the study period. The mean (SD) age of children with severe dengue and scrub typhus was 7.9(3.8) and 11.8(5.8) years, respectively. Majority of children with severe dengue presented with hypotension, 21(52.5%) vs 3(9.4%) in scrub typhus. Children with severe dengue had a relatively low ANC (2.6±1.97x103/mm3 vs 3.9±2.06x103/mm3), low platelet count (50.23±35.55x103/mm3 vs 140±95.0x103/mm3) and low mean ESR at 1hour (8.1±6.82mm vs 33.88±13.79mm) than scrub typhus.Conclusions: Compared to scrub typhus, severe dengue was significantly associated with hypotension, lower ANC, ESR and platelets.

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Mahajan, Sanjay K., und Sanyam K. Mahajan. „Neuropsychiatric Manifestations of Scrub Typhus“. Journal of Neurosciences in Rural Practice 08, Nr. 03 (Juli 2017): 421–26. http://dx.doi.org/10.4103/jnrp.jnrp_44_17.

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ABSTRACTScrub typhus is caused by Orientia tsutsugamushi characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are not uncommon but are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillan-Barré syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article reviews various neurological manifestations of scrub typhus reported in literature.

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Koraluru, Munegowda, Manideep Nandigam, Indira Bairy, Sudha Vidyasagar und Muralidhar Varma. „Multiple eschars in scrub typhus: a case report“. Tropical Doctor 47, Nr. 1 (19.07.2016): 67–69. http://dx.doi.org/10.1177/0049475516658400.

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Eschar in scrub typhus aids in early diagnosis and institution of appropriate therapy; however, the eschar positivity rates vary greatly in endemic regions. Multiple eschars in scrub typhus are a rare presentation. Our patient presented with fever and multiple eschars and was empirically started on doxycycline. Nested polymerase chain reaction from all the four eschars and from EDTA blood were positive for 56-kDa type-specific antigen which is specific for Orientia tsutsugamushi. The patient recovered completely after 7 days of antibiotic treatment. He was from an area where scrub typhus was not observed previously. An eschar in an acute febrile patient from the “tsutsugamushi triangle” is a valuable sign in scrub typhus diagnosis. A search for multiple eschars in scrub typhus must be made by clinicians.

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Tanabe, Melinda, Lucas Blanton, Mauricio La Rosa de Los Rios und Camille Webb Camminati. „2128. Murine Typhus and Pregnancy: Case Series and Literature Review“. Open Forum Infectious Diseases 6, Supplement_2 (Oktober 2019): S720—S721. http://dx.doi.org/10.1093/ofid/ofz360.1808.

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Abstract Background Murine typhus is an arthropod borne disease of worldwide distribution with recent reemergence in the United States of America. There is limited data about the presentation, treatment and outcomes in the pregnant population. We report two cases of murine typhus in pregnancy, as well as a case series based in literature published between 1990 and 2019. Methods A comprehensive search in Pubmed database using words murine typhus, pregnancy, R. typhi and endemic typhus was done. Exclusion criteria were asymptomatic murine typhus in pregnancy and undiagnosed febrile illness in pregnancy. Results Six articles met the criteria of symptomatic pregnant murine typhus infection. Four case reports plus our own 2 case reports, and 2 observational population studies. A total of 35 pregnancy patients were identified. Distribution was worldwide. Gestational age at presentation varied. Patients frequently presented with prolonged duration of fevers prior to presentation, headache, rash, thrombocytopenia and elevated hepatic transaminases. Diagnosis was mainly based on serology. Treatment varied and 8 cases did not receive any treatment at all. Overall pregnancy outcome was favorable, except in an Asian cohort reporting 6 patients with poor pregnancy outcomes. Conclusion The lack of data about murine typhus in pregnancy is of serious concern. Increase awareness of different presentations is needed in this population. Murine typhus infection can mimic other pregnancy-related pathologies that have very different treatments and outcomes. More data are needed about effective treatment and safety of doxycycline use during pregnancy. Disclosures All authors: No reported disclosures.

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Islam, Asraful, Rajdeep Saha und Arup Roy. „Scrub Typhus – A Threatening Scenario in North Bengal“. Journal of Evidence Based Medicine and Healthcare 8, Nr. 39 (27.09.2021): 3417–22. http://dx.doi.org/10.18410/jebmh/2021/620.

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BACKGROUND Scrub typhus is a mite borne zoonotic bacterial disease caused by Orientia tsutsugamushi. It is transmitted by bite of chiggers of trombiculid mite. Clinical features generally include fever, headache, and myalgia, with or without eschar/rash. People with severe illness may develop organ failure and bleeding which can be fatal if left untreated. This study was done to detect outbreak of cases of scrub typhus in Eastern India. These mites generally live in paddy fields of forested area and people visiting those areas are generally affected. Now a days these mites migrate to urban area resulting in increased incidence of scrub typhus infection in urban area. This study was conducted in collaboration with another institute. The purpose of this study was to find out the incidence of scrub typhus in our area and the relationship between occurrence of scrub typhus and seasonal, age and sex variation. METHODS This study was carried out in our tertiary care hospital with 441 samples for a period of one year (01.01.2019 to 31.12.19). All the blood samples collected from febrile patients were subjected to Weil Felix test. If the titre is > 1 : 160; this was further confirmed by specific IgM testing. Both Weil-Felix tests and IgM scrub typhus positive tests were noted. RESULTS Out of 441 samples, 98 (22.2 %, n = 441) samples were positive for both WeilFelix and scrub typhus IgM by enzyme linked immunosorbent assay (ELISA) testing. Most of the cases were seen in males. Seasonal distribution showed higher cases in the months of September and October. CONCLUSIONS In our study, the highest numbers of scrub typhus cases were found in rural areas, during the harvesting period of July–September specially in monsoon or post monsoon period when there is abundance of mite larva. This infection is also reported high in cases among children in the age group of 1 - 14 years. Patients who tested positive for scrub typhus improved radically with doxycycline. KEYWORDS Orientia Tsutsugamushi, Scrub Typhus, IgM ELISA

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Islam, Asraful, Rajdeep Saha und Arup Roy. „Scrub Typhus – A Threatening Scenario in North Bengal“. Journal of Evidence Based Medicine and Healthcare 8, Nr. 39 (27.09.2021): 3417–22. http://dx.doi.org/10.18410/jebmh/2021/620.

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BACKGROUND Scrub typhus is a mite borne zoonotic bacterial disease caused by Orientia tsutsugamushi. It is transmitted by bite of chiggers of trombiculid mite. Clinical features generally include fever, headache, and myalgia, with or without eschar/rash. People with severe illness may develop organ failure and bleeding which can be fatal if left untreated. This study was done to detect outbreak of cases of scrub typhus in Eastern India. These mites generally live in paddy fields of forested area and people visiting those areas are generally affected. Now a days these mites migrate to urban area resulting in increased incidence of scrub typhus infection in urban area. This study was conducted in collaboration with another institute. The purpose of this study was to find out the incidence of scrub typhus in our area and the relationship between occurrence of scrub typhus and seasonal, age and sex variation. METHODS This study was carried out in our tertiary care hospital with 441 samples for a period of one year (01.01.2019 to 31.12.19). All the blood samples collected from febrile patients were subjected to Weil Felix test. If the titre is > 1 : 160; this was further confirmed by specific IgM testing. Both Weil-Felix tests and IgM scrub typhus positive tests were noted. RESULTS Out of 441 samples, 98 (22.2 %, n = 441) samples were positive for both WeilFelix and scrub typhus IgM by enzyme linked immunosorbent assay (ELISA) testing. Most of the cases were seen in males. Seasonal distribution showed higher cases in the months of September and October. CONCLUSIONS In our study, the highest numbers of scrub typhus cases were found in rural areas, during the harvesting period of July–September specially in monsoon or post monsoon period when there is abundance of mite larva. This infection is also reported high in cases among children in the age group of 1 - 14 years. Patients who tested positive for scrub typhus improved radically with doxycycline. KEYWORDS Orientia Tsutsugamushi, Scrub Typhus, IgM ELISA