Scrub typhus is widely endemic in Asia. Man’s behaviour and climatic changes greatly influence the occurrence of the disease. Increasing prevalences of scrub typhus have been reported from some Asian countries and may coincide with the widespread use of beta-lactam antibiotics, improved diagnostic facilities, and/or increasing urbanisation into rural areas. Many cases acquired in Asia have surfaced in Europe and America. The disease probably is overlooked among paediatric patients. Most patients with scrub typhus present with acute fever of unknown origin (acute FUO). Eschars are rare among Southeast Asian patients.
Complications usually develop after the first week of illness. These include pneumonitis, meningoencephalitis, renal failure and jaundice. Improved serological and molecular diagnostic tests are now available. Although drug-resistant strains of Orientia tsutsugamushi have been reported, the infection usually responds to simple but unpopular drugs such as doxycycline or chloramphenicol.
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The author(s) declare there are no affiliations with or involvement in any organisation or entity with any financial interest in the subject matter or materials discussed in this manuscript.
