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MeSH Review

Scrub Typhus

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Disease relevance of Scrub Typhus

  • METHODS: Serial HIV-1 viral load determinations were made in ten Thai adults with scrub typhus, who were not receiving antiretroviral therapy, and in five HIV-1-infected patients who had other infections (four malaria, one leptospirosis), during and after acute infections [1].
  • The results of this study suggest that O. tsutsugamushi does invade the CSF and that scrub typhus should be considered one of the causes of mononuclear meningitis in areas of endemicity [2].
  • Thai patients with scrub typhus caused by the intracellular pathogen Orientia tsutsugamushi displayed elevated plasma concentrations of granzymes A and B, interferon-gamma (IFN)-gamma-inducible protein 10, and monokine induced by IFN-gamma [3].
  • Eleven other sera (1.2%) were positive for scrub typhus and spotted fever group rickettsiae and four (0.4%) were positive for scrub typhus, spotted fever group, and typhus group rickettsiae [4].
  • A patient was admitted to our hospital with fever of unknown origin, lymphadenopathy and moderate anemia.The diagnosis of scrub typhus (tsutsugamushi disease) was established on specific serologic demonstration of antibodies to the cross-reacting proteins OX-K antigen and reaffirmed by successful treatment with doxycycline [5].

High impact information on Scrub Typhus


Chemical compound and disease context of Scrub Typhus


Biological context of Scrub Typhus


Anatomical context of Scrub Typhus


Gene context of Scrub Typhus

  • To understand the pathogenesis of scrub typhus, we examined chemokine and cytokine production after infection with O. tsutsugamushi in mice [20].
  • The dipstick assays were the Integrated Diagnostics (Baltimore, MD) Dip-S-Ticks Scrub Recombinant (r56) dipstick test (INDX assay) and the PanBio (Brisbane, Australia) Scrub Typhus IgM and IgG Rapid Immunochromatographic test (PanBio assay) [21].
  • IFN-gamma, interleukin (IL)-18, and IL-15 levels were elevated only in patients with scrub typhus, whereas IL-12p40 and tumor necrosis factor-alpha concentrations were elevated in both patient groups, although more so in scrub typhus [22].
  • Theses primers led to a 78-bp fragment by amplifying the genomic DNAs from five serovariants, i.e., the Gilliam, Karp, Kato, Kawasaki, and Kuroki strains of R. tsutsugamushi, and also the DNA from blood clots of patients with scrub typhus, even at the early stage of onset of the disease [23].
  • A polymerase chain reaction system for rapid diagnosis of scrub typhus within six hours [24].

Analytical, diagnostic and therapeutic context of Scrub Typhus


  1. HIV-1 suppression during acute scrub-typhus infection. Watt, G., Kantipong, P., de Souza, M., Chanbancherd, P., Jongsakul, K., Ruangweerayud, R., Loomis-Price, L.D., Polonis, V., Myint, K.S., Birx, D.L., Brown, A.E., Krishna, S. Lancet (2000) [Pubmed]
  2. Central nervous system involvement in patients with scrub typhus. Pai, H., Sohn, S., Seong, Y., Kee, S., Chang, W.H., Choe, K.W. Clin. Infect. Dis. (1997) [Pubmed]
  3. Activation of cytotoxic lymphocytes in patients with scrub typhus. de Fost, M., Chierakul, W., Pimda, K., Dondorp, A.M., White, N.J., Van der Poll, T. Am. J. Trop. Med. Hyg. (2005) [Pubmed]
  4. Rickettsia serosurvey in Kimberley, Western Australia. Graves, S., Wang, L., Nack, Z., Jones, S. Am. J. Trop. Med. Hyg. (1999) [Pubmed]
  5. Scrub typhus-associated hemophagocytic syndrome. Chen, Y.C., Chao, T.Y., Chin, J.C. Infection (2000) [Pubmed]
  6. Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial. Watt, G., Kantipong, P., Jongsakul, K., Watcharapichat, P., Phulsuksombati, D., Strickman, D. Lancet (2000) [Pubmed]
  7. Chloramphenicol, gentamicin, and ciprofloxacin against murine scrub typhus. McClain, J.B., Joshi, B., Rice, R. Antimicrob. Agents Chemother. (1988) [Pubmed]
  8. Host defenses in experimental scrub typhus: inflammatory response of congenic C3H mice differing at the Ric gene. Jerrells, T.R., Osterman, J.V. Infect. Immun. (1981) [Pubmed]
  9. Host defenses in experimental scrub typhus: effect of chloramphenicol. Shirai, A., Catanzaro, P.J., Eisenberg, G.H., Osterman, J.V. Infect. Immun. (1977) [Pubmed]
  10. Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial. Song, J.H., Lee, C., Chang, W.H., Choi, S.W., Choi, J.E., Kim, Y.S., Cho, S.R., Ryu, J., Pai, C.H. Clin. Infect. Dis. (1995) [Pubmed]
  11. Azithromycin therapy for scrub typhus during pregnancy. Choi, E.K., Pai, H. Clin. Infect. Dis. (1998) [Pubmed]
  12. Roxithromycin treatment of scrub typhus (tsutsugamushi disease) in children. Lee, K.Y., Lee, H.S., Hong, J.H., Hur, J.K., Whang, K.T. Pediatr. Infect. Dis. J. (2003) [Pubmed]
  13. An unusual site of chigger bite in a patient with scrub typhus. Lau, S.M., Yu, W.L., Wang, J.H. Diagn. Microbiol. Infect. Dis. (1999) [Pubmed]
  14. Molecular cloning and sequence analysis of a Rickettsia tsutsugamushi 22 kDa antigen containing B- and T-cell epitopes. Hickman, C.J., Stover, C.K., Joseph, S.W., Oaks, E.V. Microb. Pathog. (1991) [Pubmed]
  15. Lack of transplacental infection with scrub typhus organisms in laboratory mice. Shirai, A., Chan, T.C., Gan, E., Groves, M.G. Am. J. Trop. Med. Hyg. (1984) [Pubmed]
  16. Case reports: scrub typhus during pregnancy in India. Mathai, E., Rolain, J.M., Verghese, L., Mathai, M., Jasper, P., Verghese, G., Raoult, D. Trans. R. Soc. Trop. Med. Hyg. (2003) [Pubmed]
  17. Orientia tsutsugamushi suppresses the production of inflammatory cytokines induced by its own heat-stable component in murine macrophages. Kim, M.K., Kang, J.S. Microb. Pathog. (2001) [Pubmed]
  18. Interferon-gamma in cerebrospinal fluid without pleocytosis in scrub typhus. Ikeda, M., Yoshida, S., Tsukagoshi, H. J. Neurol. Sci. (1992) [Pubmed]
  19. Enzymatic activity of blood lymphocytes experimental tsutsugamushi fever in mice. Miskarova, E.D., Kekcheeva, N.G. Acta Virol. (1977) [Pubmed]
  20. Chemokine and cytokine production during Orientia tsutsugamushi infection in mice. Koh, Y.S., Yun, J.H., Seong, S.Y., Choi, M.S., Kim, I.S. Microb. Pathog. (2004) [Pubmed]
  21. Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Coleman, R.E., Sangkasuwan, V., Suwanabun, N., Eamsila, C., Mungviriya, S., Devine, P., Richards, A.L., Rowland, D., Ching, W.M., Sattabongkot, J., Lerdthusnee, K. Am. J. Trop. Med. Hyg. (2002) [Pubmed]
  22. Differential expression of interferon-gamma and interferon-gamma-inducing cytokines in Thai patients with scrub typhus or leptospirosis. Chierakul, W., de Fost, M., Suputtamongkol, Y., Limpaiboon, R., Dondorp, A., White, N.J., van der Poll, T. Clin. Immunol. (2004) [Pubmed]
  23. Specific amplification of Rickettsia tsutsugamushi DNA from clinical specimens by polymerase chain reaction. Furuya, Y., Yoshida, Y., Katayama, T., Kawamori, F., Yamamoto, S., Ohashi, N., Tamura, A., Kawamura, A. J. Clin. Microbiol. (1991) [Pubmed]
  24. A polymerase chain reaction system for rapid diagnosis of scrub typhus within six hours. Sugita, Y., Yamakawa, Y., Takahashi, K., Nagatani, T., Okuda, K., Nakajima, H. Am. J. Trop. Med. Hyg. (1993) [Pubmed]
  25. Doxycycline propylaxis for human scrub typhus. Twartz, J.C., Shirai, A., Selvaraju, G., Saunders, J.P., Huxsoll, D.L., Groves, M.G. J. Infect. Dis. (1982) [Pubmed]
  26. Sensitive microplate enzyme-linked immunosorbent assay for detection of antibodies against the scrub typhus rickettsia, Rickettsia tsutsugamushi. Dasch, G.A., Halle, S., Bourgeois, A.L. J. Clin. Microbiol. (1979) [Pubmed]
  27. Prevention of scrub typhus. Prophylactic administration of doxycycline in a randomized double blind trial. Olson, J.G., Bourgeois, A.L., Fang, R.C., Coolbaugh, J.C., Dennis, D.T. Am. J. Trop. Med. Hyg. (1980) [Pubmed]
  28. Immunoblotting analysis of anti-rickettsial antibodies produced in patients of Tsutsugamushi disease. Ohashi, N., Tamura, A., Suto, T. Microbiol. Immunol. (1988) [Pubmed]
  29. Diagnosis of scrub typhus in Malaysian aborigines using nested polymerase chain reaction. Tay, S.T., Nazma, S., Rohani, M.Y. Southeast Asian J. Trop. Med. Public Health (1996) [Pubmed]
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