Clinical Features and Diagnosis of Scrub Typhus

Scrub typhus is the most common rickettsial disease in Korea. Scrub typhus is an acute febrile illness with characteristic findings such as high fever, rash, headache, and eschar. It is caused by intracellular gram-negative bacteria Orientia tsutsugamushi. Infection occurs when larvae of thrombiculid mite (chiggers) infected with O. tsutsugamushi bite people and suck human tissue fluid. Although scrub typhus runs a mild clinical course and shows a good response to antibiotic therapy, serious complications such as interstitial pneumonia, acute renal failure, meningoencephalitis, gastrointestinal bleeding, and multiple organ failure may develop when diagnosis is delayed and can even lead to death. It is often difficult to diagnose scrub typhus only by clinical features and therefore, more rapid and accurate diagnostic evaluation may be required. This review will focus on clinical feature, and diagnosis of scrub typhus.