Diagnostic challenges and antibody kinetics in a paediatric traveller with scrub typhus

Journal article

Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness highly prevalent in South and Southeast Asia. Diagnosing this disease in travellers is challenging due to the shared clinical symptoms with other travel-related febrile illnesses and the limited availability of early diagnostic tools. Consequently, travel medicine practitioners heavily rely on history-taking and physical examination for disease identification. The key diagnostic marker is an eschar, a distinctive necrotic skin lesion that forms at the site of chigger bite. However, it may not consistently manifest in affected individuals and is often painless, making it easy to go unnoticed by the host.

This study presents a case of a paediatric traveller with scrub typhus, with a specific focus on the evolution of the eschar, laboratory findings and antibody dynamics. It highlights the importance of a cautious interpretation of conventional diagnostic tests and underscores the significance of comprehensive history-taking and physical examination when diagnosing scrub typhus in febrile travellers.

Authors: Looareesuwan, P; Aiemjoy, K; Charoensakulchai, S; Thaipadungpanit, J; Wongsantichon, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: Journal of Travel Medicine
• Volume: 30
• Issue: 8
• Article number: taad143
• Publication date: 2023-11-11
• Acceptance date: 2023-11-03
• DOI: 10.1093/jtm/taad143
• EISSN: 1708-8305
• ISSN: 1195-1982
• Pmid: 37952213
• Language: English
• Keywords: FFR; ELISA; antibody dynamics; rickettsia infection; Orientia tsutsugamushi; returned travellers; travel-associated illness