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Metagenomic next-generation sequencing helped diagnose scrub typhus without eschar: A case report.
Int J Infect Dis. 2020 Jan; 90:1-4.IJ

Abstract

BACKGROUND

Scrub typhus is caused by Orientia tsutsugamushi. Clinical manifestations include fever, rash, eschar at the bite site, and other non-specific flu-like symptoms. The eschar is a dark, scab-like area at the bite site, and is the typical lesions that prompts a diagnosis of O. tsutsugamushi. Without eschar lesions, it is difficult to identify scrub typhus. However, metagenomic next-generation sequencing (mNGS) can be used to identify infections, and this novel method may help improve clinical diagnosis.

CASE PRESENTATION

Here, we report a case of scrub typhus in a 51-year-old woman who presented to the emergency department with a week-long fever from an unknown cause. We used mNGS to search for an infectious etiology, and the mNGS suggested O. tsutsugamushi, which was unexpectedly detected.

DISCUSSION AND CONCLUSION

This study suggests that mNGS may be a useful diagnostic tool to identify clinical, causative pathogens in fever, particular ones with atypical features.

Authors+Show Affiliations

Department of Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China. Electronic address: 21618157@zju.edu.cn.Western Reserve Academy 115 College Street, Hudson, OH 44236, United States. Electronic address: wuy20@wra.net.Department of Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China. Electronic address: huangman@zju.edu.cn.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31648003

Citation

Wu, Jing, et al. "Metagenomic Next-generation Sequencing Helped Diagnose Scrub Typhus Without Eschar: a Case Report." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 90, 2020, pp. 1-4.
Wu J, Wu Y, Huang M. Metagenomic next-generation sequencing helped diagnose scrub typhus without eschar: A case report. Int J Infect Dis. 2020;90:1-4.
Wu, J., Wu, Y., & Huang, M. (2020). Metagenomic next-generation sequencing helped diagnose scrub typhus without eschar: A case report. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 90, 1-4. https://doi.org/10.1016/j.ijid.2019.10.020
Wu J, Wu Y, Huang M. Metagenomic Next-generation Sequencing Helped Diagnose Scrub Typhus Without Eschar: a Case Report. Int J Infect Dis. 2020;90:1-4. PubMed PMID: 31648003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metagenomic next-generation sequencing helped diagnose scrub typhus without eschar: A case report. AU - Wu,Jing, AU - Wu,Yumeng, AU - Huang,Man, Y1 - 2019/10/21/ PY - 2019/06/20/received PY - 2019/10/14/revised PY - 2019/10/16/accepted PY - 2019/10/28/pubmed PY - 2020/3/7/medline PY - 2019/10/25/entrez KW - Eschars KW - Fever KW - Next-generation sequencing KW - Orientia tsutsugamushi SP - 1 EP - 4 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 90 N2 - BACKGROUND: Scrub typhus is caused by Orientia tsutsugamushi. Clinical manifestations include fever, rash, eschar at the bite site, and other non-specific flu-like symptoms. The eschar is a dark, scab-like area at the bite site, and is the typical lesions that prompts a diagnosis of O. tsutsugamushi. Without eschar lesions, it is difficult to identify scrub typhus. However, metagenomic next-generation sequencing (mNGS) can be used to identify infections, and this novel method may help improve clinical diagnosis. CASE PRESENTATION: Here, we report a case of scrub typhus in a 51-year-old woman who presented to the emergency department with a week-long fever from an unknown cause. We used mNGS to search for an infectious etiology, and the mNGS suggested O. tsutsugamushi, which was unexpectedly detected. DISCUSSION AND CONCLUSION: This study suggests that mNGS may be a useful diagnostic tool to identify clinical, causative pathogens in fever, particular ones with atypical features. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/31648003/Metagenomic_next_generation_sequencing_helped_diagnose_scrub_typhus_without_eschar:_A_case_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(19)30413-8 DB - PRIME DP - Unbound Medicine ER -