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Scrub typhus and antibiotic-resistant Orientia tsutsugamushi.
Expert Rev Anti Infect Ther. 2021 12; 19(12):1519-1527.ER

Abstract

Introduction: Scrub typhus is one of the most underdiagnosed and under-reported febrile illnesses requiring hospitalization, mainly occurring in Southeast and East Asia and the Pacific Islands, in an area referred to as the 'Tsutsugamushi Triangle.' Scrub typhus is a zoonotic rickettsial disease that is transmitted to humans by trombiculid mites.Areas covered: A MEDLINE/PubMed search of the available literature was performed to describe the role of antibiotic-resistant scrub typhus in therapy failure.Expert opinion: Scrub typhus is characterized by an eschar that may appear 2-3 days before sudden-onset fever with chills, headache, backache, myalgia, profuse sweating, vomiting, and enlarged lymph nodes. A macular or maculopapular skin rash can develop within 3-8 days after the onset of fever. Various antibiotics, such as chloramphenicol, tetracycline, doxycycline, macrolides, quinolones, and rifampicin, have been used to treat scrub typhus. Resistance to tetracycline has been proposed to underlie delayed clinical improvement since 1996, but recent reports have questioned the existence of doxycycline resistance. Nevertheless, the existence and importance of antibiotic-resistant scrub typhus remain uncertain and require further study.

Authors+Show Affiliations

Department of Infectious Diseases, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.Division of Infectious Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

34109905

Citation

Lu, Chin-Te, et al. "Scrub Typhus and Antibiotic-resistant Orientia Tsutsugamushi." Expert Review of Anti-infective Therapy, vol. 19, no. 12, 2021, pp. 1519-1527.
Lu CT, Wang LS, Hsueh PR. Scrub typhus and antibiotic-resistant Orientia tsutsugamushi. Expert Rev Anti Infect Ther. 2021;19(12):1519-1527.
Lu, C. T., Wang, L. S., & Hsueh, P. R. (2021). Scrub typhus and antibiotic-resistant Orientia tsutsugamushi. Expert Review of Anti-infective Therapy, 19(12), 1519-1527. https://doi.org/10.1080/14787210.2021.1941869
Lu CT, Wang LS, Hsueh PR. Scrub Typhus and Antibiotic-resistant Orientia Tsutsugamushi. Expert Rev Anti Infect Ther. 2021;19(12):1519-1527. PubMed PMID: 34109905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scrub typhus and antibiotic-resistant Orientia tsutsugamushi. AU - Lu,Chin-Te, AU - Wang,Lih-Shinn, AU - Hsueh,Po-Ren, Y1 - 2021/06/21/ PY - 2021/6/11/pubmed PY - 2022/4/22/medline PY - 2021/6/10/entrez KW - Orientia tsutsugamushi KW - antibiotic-resistant KW - rickettsial infection KW - scrub typhus KW - tsutsugamushi triangle SP - 1519 EP - 1527 JF - Expert review of anti-infective therapy JO - Expert Rev Anti Infect Ther VL - 19 IS - 12 N2 - Introduction: Scrub typhus is one of the most underdiagnosed and under-reported febrile illnesses requiring hospitalization, mainly occurring in Southeast and East Asia and the Pacific Islands, in an area referred to as the 'Tsutsugamushi Triangle.' Scrub typhus is a zoonotic rickettsial disease that is transmitted to humans by trombiculid mites.Areas covered: A MEDLINE/PubMed search of the available literature was performed to describe the role of antibiotic-resistant scrub typhus in therapy failure.Expert opinion: Scrub typhus is characterized by an eschar that may appear 2-3 days before sudden-onset fever with chills, headache, backache, myalgia, profuse sweating, vomiting, and enlarged lymph nodes. A macular or maculopapular skin rash can develop within 3-8 days after the onset of fever. Various antibiotics, such as chloramphenicol, tetracycline, doxycycline, macrolides, quinolones, and rifampicin, have been used to treat scrub typhus. Resistance to tetracycline has been proposed to underlie delayed clinical improvement since 1996, but recent reports have questioned the existence of doxycycline resistance. Nevertheless, the existence and importance of antibiotic-resistant scrub typhus remain uncertain and require further study. SN - 1744-8336 UR - https://www.unboundmedicine.com/medline/citation/34109905/Scrub_typhus_and_antibiotic_resistant_Orientia_tsutsugamushi_ L2 - https://www.tandfonline.com/doi/full/10.1080/14787210.2021.1941869 DB - PRIME DP - Unbound Medicine ER -