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Scrub typhus

Hugh W Kingston, Mosharraf Hossain, Stije Leopold, Tippawan Anantatat, Ampai Tanganuchitcharnchai, Ipsita Sinha, Katherine Plewes, Richard J Maude, M A Hassan Chowdhury, Sujat Paul, Rabiul Alam Mohammed Erfan Uddin, Mohammed Abu Naser Siddiqui, Abu Shahed Zahed, Abdullah Abu Sayeed, Mohammed Habibur Rahman, Anupam Barua, Mohammed Jasim Uddin, Mohammed Abdus Sattar, Arjen M Dondorp, Stuart D Blacksell, Nicholas P J Day, Aniruddha Ghose, Amir Hossain, Daniel H Paris
We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains...
April 2018: Emerging Infectious Diseases
Yong Qi, Qiong Yin, Yinxiu Shao, Min Cao, Suqin Li, Hongxia Chen, Wanpeng Shen, Jixian Rao, Jiameng Li, Xiaoling Li, Yu Sun, Yu Lin, Yi Deng, Wenwen Zeng, Shulong Zheng, Suyun Liu, Yuexi Li
OBJECTIVES: Orientia tsutsugamushi is an obligate intracellular pathogen that causes scrub typhus. Diagnosing scrub typhus is still a challenge and sensitive, specific, simple, and rapid diagnostic tests is in need. METHODS: Recombinase polymerase amplification (RPA) assay combined with a lateral flow (LF) test was developed and optimized targeting 56-kDa gene of a Karp-like strain of O. tsutsugamushi. Detection limits, sensitivity, specificity, and simulative clinical performance were evaluated...
March 13, 2018: International Journal of Infectious Diseases: IJID
Kirti Gupta, Chirag K Ahuja, Awadh K Pandit, Manisha Biswal, M R Shivaprakash
While neurological manifestations in scrub typhus have been well described both in clinical and radiological reports in the literature, neuropathological features are rarely reported. They range from subtle "typhus nodules" to more widespread capillaritis. Familiarity with pathological features is essential for correct interpretation. We describe the clinical, imaging, and histological findings in an autopsy case of scrub typhus, which was pre-terminally superimposed by fungal meningoencephalitis...
March 2018: Neurology India
Kyung Duk Min, Sung Il Cho
BACKGROUND: The incidence rate of scrub typhus has been increasing in the Republic of Korea. Previous studies have suggested that this trend may have resulted from the effects of climate change on the transmission dynamics among vectors and hosts, but a clear explanation of the process is still lacking. In this study, we applied mathematical models to explore the potential factors that influence the epidemiology of tsutsugamushi disease. METHODS: We developed mathematical models of ordinary differential equations including human, rodent and mite groups...
March 19, 2018: Journal of Korean Medical Science
Prabahs Prasun Giri, Joydeb Roy, Agnisekhar Saha
Aim of the Study: Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. Materials and Methods: This study was done in a pediatric teaching hospital in Kolkata, India...
February 2018: Indian Journal of Critical Care Medicine
Piyanate Sunyakumthorn, Suwit J Somponpun, Rawiwan Im-Erbsin, Tippawan Anantatat, Kemajittra Jenjaroen, Susanna J Dunachie, Eric D Lombardini, Robin L Burke, Stuart D Blacksell, James W Jones, Carl J Mason, Allen L Richards, Nicholas P J Day, Daniel H Paris
BACKGROUND: Scrub typhus is an important endemic disease in tropical Asia caused by Orientia tsutsugamushi for which no effective broadly protective vaccine is available. The successful evaluation of vaccine candidates requires well-characterized animal models and a better understanding of the immune response against O. tsutsugamushi. While many animal species have been used to study host immunity and vaccine responses in scrub typhus, only limited data exists in non-human primate (NHP) models...
March 9, 2018: PLoS Neglected Tropical Diseases
Vikas Shrivastava, Sohaib Ahmad, Garima Mittal, Vibha Gupta, Nadia Shirazi, Varun Kalra
Background: In this follow-up study, we aimed to establish the cut-off values of the volume, conductivity and scatter (VCS) parameters of leucocytes that significantly differ in dengue fever, malaria, scrub typhus and enteric fever, as described in our pilot study. Methods: A prospective observational case-control study was undertaken on patients with an established diagnosis of acute malaria (n=476), dengue fever (n=927), scrub typhus (n=425), bacterial sepsis (n=1598) or enteric fever (n=885) and the haematological and VCS data obtained by the Coulter LH 750 analyser were compared with controls...
March 2, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Rawadee Kumlert, Kittipong Chaisiri, Tippawan Anantatat, Alexandr A Stekolnikov, Serge Morand, Anchana Prasartvit, Benjamin L Makepeace, Sungsit Sungvornyothin, Daniel H Paris
BACKGROUND: Conventional gold standard characterization of chigger mites involves chemical preparation procedures (i.e. specimen clearing) for visualization of morphological features, which however contributes to destruction of the arthropod host DNA and any endosymbiont or pathogen DNA harbored within the specimen. METHODOLOGY/PRINCIPAL FINDINGS: In this study, a novel work flow based on autofluorescence microscopy was developed to enable identification of trombiculid mites to the species level on the basis of morphological traits without any special preparation, while preserving the mite DNA for subsequent genotyping...
2018: PloS One
Louise E van Eekeren, Sophia G de Vries, Jiri F P Wagenaar, René Spijker, Martin P Grobusch, Abraham Goorhuis
BACKGROUND: Rickettsial diseases present as acute febrile illnesses, sometimes with inoculation eschars. METHODS: We performed a systematic review of studies published between 1997 and 2017 to assess the underestimation of non-eschar rickettsial disease (NERD) relative to eschar rickettsial disease (ERD), as a cause of acute fever in patients with rickettsial diseases that commonly present with eschar(s): scrub typhus (ST), Mediterranean spotted fever (MSF), and African tick-bite fever...
February 24, 2018: Travel Medicine and Infectious Disease
Yun Sung Kim, Dong-Min Kim, Na-Ra Yoon, Mi-Sun Jang, Choon-Mee Kim
Background: Doxycycline is currently the most frequently used treatment in patients with scrub typhus, but doxycycline-resistant strains have been found, necessitating the development of a new treatment. Rifampin is known to be effective even for such strains. Thus, this study aimed to compare the effects of rifampin and doxycycline treatment in patients with scrub typhus in areas in which resistance to doxycycline has not been reported. Methods: Patients admitted to Chosun University Hospital and regional network hospitals between 2007 and 2009 with a body temperature of 37...
February 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
H Lalrinkima, R Lalremruata, C Lalchhandama, Lalthansanga Khiangte, Freddy H Siamthara, C Lalnunpuia, S K Borthakur, Gautam Patra
No abstract text is available yet for this article.
October 2017: Journal of Vector Borne Diseases
Parul Jain, Shantanu Prakash, Danish N Khan, Ravindra Kumar Garg, Rashmi Kumar, Amit Bhagat, V Ramakrishna, Amita Jain
Background & objectives: It is imperative to know the aetiology of acute encephalitis syndrome (AES) for patient management and policy making. The present study was carried out to determine the prevalence of common aetiological agents of AES in Uttar Pradesh (UP) state of India. Methods: Serum and/or CSF samples were collected from AES patients admitted at Gandhi Memorial and Associated Hospital, King George's Medical University, Lucknow, a tertiary care centre, UP during 2014-16...
October 2017: Journal of Vector Borne Diseases
Edmond Changkyun Park, Sang-Yeop Lee, Sung Ho Yun, Chi-Won Choi, Hayoung Lee, Hyun Seok Song, Sangmi Jun, Gun-Hwa Kim, Chang-Seop Lee, Seung Il Kim
Background: Scrub typhus is an acute and febrile infectious disease caused by the Gram-negative α-proteobacterium Orientia tsutsugamushi from the family Rickettsiaceae that is widely distributed in Northern, Southern and Eastern Asia. In the present study, we analysed the serum proteome of scrub typhus patients to investigate specific clinical protein patterns in an attempt to explain pathophysiology and discover potential biomarkers of infection. Methods: Serum samples were collected from three patients (before and after treatment with antibiotics) and three healthy subjects...
2018: Clinical Proteomics
Lynn Soong
Scrub typhus is an emerging, insect-transmitted disease caused by Orientia tsutsugamushi, a Gram- and LPS-negative bacterium that replicates freely within professional phagocytes and endothelial cells. Scrub typhus is prevalent with high mortality rates, but information regarding its molecular pathogenesis, microbial virulence determinants, and key immune responses is limited. Improved animal models have recently been developed that respectively resemble the pathological features of self-limiting or severe scrub typhus in humans...
February 15, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Gunasekaran Karthik, Thomas Isaiah Sudarsan, John Victor Peter, Thambu Sudarsanam, George M Varghese, Paul Kundavaram, Sowmya Sathyendra, Ramya Iyyadurai, Kishore Pichamuthu
AIM: To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes. METHODS: Demographic data, electrocardiographic (ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio (OR) with 95%CI...
February 4, 2018: World Journal of Critical Care Medicine
Yogendra Pandurang Shelke, Vijayshri Suresh Deotale, Deepashri Laxmanrao Maraskolhe
INTRODUCTION: Infectious agent when enters in the host results in febrile illness. This may lead to increase in morbidity or even mortality in undiagnosed/untreated cases. There are many aetiological agents which lead to acute febrile illness. Among these aetiological agents, important is bacterial or viral aetiology. OBJECTIVE: The objective of this study is: (i) To know the aetiological agents responsible for acute undifferentiated febrile illness (AUFI) by serological test or by bacterial culture and (ii) To know the clinical profile of AUFI...
October 2017: Indian Journal of Medical Microbiology
Svas Raju Kakarlapudi, Anila Chacko, Prasanna Samuel, Valsan Philip Verghese, Winsley Rose
OBJECTIVE: To compare scrub typhus meningitis with bacterial and tuberculous meningitis. METHODS: Children aged <15 years admitted with meningitis were screened and those who fit criteria for diagnosis of scrub typhus meningitis (n=48), bacterial meningitis (n=44) and tuberculous meningitis (n=31) were included for analysis. Clinical features, investigations and outcomes were compared between the three types of meningitis. RESULTS: Mean age, duration of fever at presentation, presence of headache and, altered sensorium and presence of hepatomegaly/splenomegaly were statistically significantly different between the groups...
January 15, 2018: Indian Pediatrics
Stalin Viswanathan
No abstract text is available yet for this article.
January 15, 2018: Indian Pediatrics
Fabián E Díaz, Katia Abarca, Alexis M Kalergis
The obligate intracellular bacterium Orientia tsutsugamushi is the causative agent of scrub typhus in humans, a serious mite-borne disease present in a widespread area of endemicity, which affects an estimated 1 million people every year. This disease may exhibit a broad range of presentations, ranging from asymptomatic to fatal conditions, with the latter being due to disseminated endothelial infection and organ injury. Unique characteristics of the biology and host-pathogen interactions of O. tsutsugamushi , including the high antigenic diversity among strains and the highly variable, short-lived memory responses developed by the host, underlie difficulties faced in the pursuit of an effective vaccine, which is an imperative need...
April 2018: Clinical Microbiology Reviews
Y Sun, C Shi, X L Li, L Q Fang, W C Cao
Objective: To understand the epidemiological characteristics of scrub typhus and influencing factors in Yunnan province, and provide further information for the prevention and control of scrub typhus. Methods: Based on the incidence data of scrub typhus reported in Yunnan from 2006 to 2013, the epidemiological characteristics of scrub typhus were analyzed and related environmental factors were identified with panel negative binomial regression model. Results: A total of 8 980 scrub typhus cases were reported during 2006-2013 in Yunnan...
January 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
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