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Diagnosis of severe scrub typhus infection by next-generation sequencing:a case report.
BMC Infect Dis. 2020 Apr 07; 20(1):270.BI

Abstract

BACKGROUND

Scrub typhus is an acute febrile illness, which was caused by Orientia tsutsugamushi and transmitted through the bite of chiggers. The diagnosis of scrub typhus could be missed diagnosis due to the absence of the pathognomonic eschar.

CASE PRESENTATION

A 76-year-old man was hospitalized with fever and kidney injury and was diagnosed of hemorrhagic fever with renal syndrome first. However, the situation of the illness deteriorated into refractory septic shock and multiple organ dysfunction rapidly,although the treatment of anti-sepsis was used in 3rd-5th day. Orientia tsutsugamushi was determined to be the causative pathogen by Next-generation sequencing of his plasma sample in 6th day. Then, the patient was treated with doxycycline and azithromycin and recovered quickly.

CONCLUSIONS

Next-generation sequencing was a new diagnostic technology and could identify scrub typhus in accurately and fast without the pathognomonic eschar.

Authors+Show Affiliations

Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.BGI-Shanghai, Kangxin Rd, Pudong District, Shanghai, 201321, Guangdong, China.Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China. 396369199@qq.com.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32264829

Citation

Chen, Jie, et al. "Diagnosis of Severe Scrub Typhus Infection By Next-generation Sequencing:a Case Report." BMC Infectious Diseases, vol. 20, no. 1, 2020, p. 270.
Chen J, Zheng XD, Dai QH, et al. Diagnosis of severe scrub typhus infection by next-generation sequencing:a case report. BMC Infect Dis. 2020;20(1):270.
Chen, J., Zheng, X. D., Dai, Q. H., Hong, W. L., Li, Y. P., Chen, R., Ye, B. B., Mo, X. J., Cui, P., & Ruan, Z. W. (2020). Diagnosis of severe scrub typhus infection by next-generation sequencing:a case report. BMC Infectious Diseases, 20(1), 270. https://doi.org/10.1186/s12879-020-04991-y
Chen J, et al. Diagnosis of Severe Scrub Typhus Infection By Next-generation Sequencing:a Case Report. BMC Infect Dis. 2020 Apr 7;20(1):270. PubMed PMID: 32264829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of severe scrub typhus infection by next-generation sequencing:a case report. AU - Chen,Jie, AU - Zheng,Xu-Dong, AU - Dai,Qi-He, AU - Hong,Wei-Li, AU - Li,You-Peng, AU - Chen,Rui, AU - Ye,Bing-Bing, AU - Mo,Xiao-Jie, AU - Cui,Peng, AU - Ruan,Zhan-Wei, Y1 - 2020/04/07/ PY - 2020/03/02/received PY - 2020/03/25/accepted PY - 2020/4/9/entrez PY - 2020/4/9/pubmed PY - 2020/5/28/medline KW - Multiple organ dysfunction KW - Next generation sequencing KW - Orientia tsutsugamushi KW - Scrub typhus KW - Septic shock SP - 270 EP - 270 JF - BMC infectious diseases JO - BMC Infect Dis VL - 20 IS - 1 N2 - BACKGROUND: Scrub typhus is an acute febrile illness, which was caused by Orientia tsutsugamushi and transmitted through the bite of chiggers. The diagnosis of scrub typhus could be missed diagnosis due to the absence of the pathognomonic eschar. CASE PRESENTATION: A 76-year-old man was hospitalized with fever and kidney injury and was diagnosed of hemorrhagic fever with renal syndrome first. However, the situation of the illness deteriorated into refractory septic shock and multiple organ dysfunction rapidly,although the treatment of anti-sepsis was used in 3rd-5th day. Orientia tsutsugamushi was determined to be the causative pathogen by Next-generation sequencing of his plasma sample in 6th day. Then, the patient was treated with doxycycline and azithromycin and recovered quickly. CONCLUSIONS: Next-generation sequencing was a new diagnostic technology and could identify scrub typhus in accurately and fast without the pathognomonic eschar. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/32264829/Diagnosis_of_severe_scrub_typhus_infection_by_next_generation_sequencing:a_case_report_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-04991-y DB - PRIME DP - Unbound Medicine ER -