Abstract
.Scrub typhus is a life-threatening zoonotic disease, which is caused by Orientia tsutsugamushi, an obligatory intracellular Gram-negative bacterium. It is transmitted by Leptotrombidium mites in endemic regions of Southeast Asia. So far, data on imported scrub typhus cases to non-endemic areas and immunological descriptions are rare. Eleven scrub typhus cases that had been diagnosed by the German National Reference Center for Tropical Pathogens between 2010 and 2018 were retrospectively reviewed for clinical symptoms, laboratory changes, and travel destinations. Patient sera were included if follow-up samples showed simultaneous seroconversion for IgM and IgG antibody responses by immunofluorescence assays or concurrence with the first serum sample. The median of seroconversion was week 2 after symptom onset. Cytokine levels were measured over time, demonstrating simultaneously upregulated major Th1, Th2, and Th17 cytokines in the acute phase of infection followed by normalization during convalescence. This study underlines the complex mixed cytokine response elicited by scrub typhus and highlights clinical and diagnostic aspects of imported infections with O. tsutsugamushi.
Highlights
Scrub typhus is a vector-borne infection caused by Orientia tsutsugamushi
Scrub typhus is a life-threatening zoonotic disease, which is caused by Orientia tsutsugamushi, an obligatory intracellular Gram-negative bacterium
It is transmitted by Leptotrombidium mites in endemic regions of Southeast Asia
Summary
Scrub typhus is a vector-borne infection caused by Orientia tsutsugamushi. Systemic manifestations occur 5–14 days after infection, comprising most frequently fever, a maculopapular rash, lymphadenopathy, headache, and myalgia. Severe complications such as myocarditis, acute renal failure, pneumonia, and meningoencephalitis might develop, which can lead to multiple organ failure with a high case fatality rate if not adequately treated. Scrub typhus is endemic in a triangular geographic region between eastern Russia, Japan, Pakistan, and Australia.[1] confirmed autochthonous Orientia sp. Infections have been recently described in Chile[2] and the United Arab Emirates.[3] there are reports about possible scrub typhus cases in East Africa,[4,5] underlining the emerging nature of this disease. Little is known about the immunology of human infection with O. tsutsugamushi,
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
