A75.3

Clinical Causes: Infection with the bacterium Rickettsia tsutsugamushi Transmission through bites of infected chigger mites (larval mites), which are found in areas with dense vegetation and bushes Exposure to mite habitats during outdoor activities such as hiking, camping, or farming in endemic regions Poor sanitation and conditions that favor mite populations

Key Symptoms: Sudden onset of high fever Headache and muscle aches Rash that may appear on the chest, abdomen, or extremities Soar in the lymph nodes Chills and exhaustion Nausea, vomiting, or abdominal pain in some cases eschar: a dark, scab-like injury at the site of the mite bite (sometimes present)

Diagnosis Path: Diagnosing scrub typhus involves a combination of clinical evaluation and laboratory testing. Physicians typically consider the patient's history of exposure to mite habitats and the region where symptoms developed. Laboratory tests that support diagnosis include serologic tests such as indirect immunofluorescence antibody (IFA) assay, which detects antibodies against Rickettsia tsutsugamushi. Skin lesion biopsy at the site of the eschar may also aid in confirming the presence of the bacteria. Because symptoms can resemble those of other febrile illnesses, accurate diagnosis often requires specialist input.

Treatment Protocols: Treatment primarily involves antibiotics effective against rickettsial infections. Doxycycline is commonly prescribed and usually leads to rapid symptom improvement. In cases where doxycycline is unsuitable, alternative antibiotics like azithromycin or chloramphenicol may be used. Supportive care, such as hydration, rest, and management of symptoms like fever and pain, is essential. Early treatment is important to prevent complications such as organ failure, central nervous system involvement, or persistent infection.