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    Clinical significance of NGAL and KIM-1 for acute kidney injury in patients with scrub typhus.
    PLoS One 2017 18;12(4):e0175890. Epub 2017 Apr 18.
    Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.
    Background: The aim of this study is to investigate the clinical significance of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) for acute kidney injury (AKI) in patients with scrub typhus.

    Methods: From 2014 to 2015, 145 patients were diagnosed with scrub typhus. Of these, we enrolled 138 patients who were followed up until renal recovery or for at least 3 months. Read More

    Nitric oxide enhanced the growth of an obligated intracellular bacterium Orientia tsutsugamushi in murine macrophages.
    Microb Pathog 2017 Apr 12;107:335-340. Epub 2017 Apr 12.
    Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
    Orientia tsutsugamushi is the causative agent of scrub typhus. It is an obligate intracellular bacterium that grows only in eukaryotic cells. Macrophages play an important role in innate immunity by surveilling the human body for pathogens. Read More

    Clinical Profile and Complications of Scrub Typhus: Hospital-Based Study in Sub-Himalayan Region.
    J Assoc Physicians India 2016 Dec;64(12):30-34
    Senior Resident, Department of Medicine, IGMC Shimla, Himachal Pradesh.
    Background: Scrub typhus is a documented disease in Himachal Pradesh, but there have been no clinico-epidemiological studies in this area. The present study is done with IgM ELISA as a diagnostic test which has higher sensitivity and specificity as most of previous studies had used Weil Felix test as a diagnostic test.

    Methodology: This was a prospective observational study. Read More

    Dengue and Scrub Typhus Coinfection in a Patient Presenting with Febrile Illness.
    Case Rep Infect Dis 2017 13;2017:6214083. Epub 2017 Mar 13.
    Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
    Dengue fever and scrub typhus are common causes of acute febrile illness of unclear origin in Asia. Though coinfections of many vector-borne diseases have been described, articles on dengue and scrub typhus coinfection are distinctly limited. In case of coinfection with dengue and scrub typhus, vigilant monitoring of vitals, platelets transfusion, and timely treatment with doxycycline are necessary. Read More

    IAP Guidelines on Rickettsial Diseases in Children.
    Indian Pediatr 2017 Mar;54(3):223-229
    Smile Healthcare, Rehabilitation and Research Foundation, Smile Institute of Child Health, Ramdaspeth, Akola; *Department of Pediatrics, Ashwini Medical College, Solapur; and #Dr Yewale Multispeciality Hospital for Children, Navi Mumbai; for Indian Academy of Pediatrics "Guidelines on Rickettsial Diseases in Children" Committee. Correspondence to: Dr Narendra Rathi, Consultant Pediatrician, Smile Healthcare, Rehabilitation and Research Foundation, Smile Institute of Child Health, Ramdaspeth, Akola, Maharashtra, India.
    Objective: To formulate practice guidelines on rickettsial diseases in children for pediatricians across India.

    Justification: Rickettsial diseases are increasingly being reported from various parts of India. Due to low index of suspicion, nonspecific clinical features in early course of disease, and absence of easily available, sensitive and specific diagnostic tests, these infections are difficult to diagnose. Read More

    Scrub typhus meningitis in a renal transplant recipient.
    Indian J Nephrol 2017 Mar-Apr;27(2):151-153
    Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
    Scrub typhus is a rickettsial infection commonly seen in Asia. The clinical presentation ranges from nonspecific febrile illness to potentially fatal multiorgan involvement such as liver, kidney, or lung. Central nervous system involvement is uncommon. Read More

    Incidence, risk factors and clinical outcomes of acute kidney injury associated with scrub typhus: a retrospective study of 510 consecutive patients in South Korea (2001-2013).
    BMJ Open 2017 Mar 15;7(3):e013882. Epub 2017 Mar 15.
    Department of Internal Medicine, Changwon Gyeongsang National University Hospital, Changwon, Korea.
    Objectives: Renal involvement in scrub typhus ranges from simple urinary abnormalities to acute kidney injury (AKI) leading to death. This study evaluated the incidence, predictors and prognosis of AKI associated with scrub typhus according to the RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria.

    Methods: We retrospectively evaluated the medical records of patients diagnosed with scrub typhus from January 2001 to November 2013 in Gyeongsang National University Hospital. Read More

    Lateral Flow Rapid Test for Accurate and Early Diagnosis of Scrub Typhus: A Febrile Illness of Historically Military Importance in the Pacific Rim.
    Mil Med 2017 Mar;182(S1):369-375
    Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910.
    Scrub typhus (ST) is an infection caused by Orientia tsutsugamushi. Historically, ST was ranked as the second most important arthropod-borne medical problem only behind malaria during World War II and the Vietnam War. The disease occurs mainly in Southeast Asia and has been shown to emerge and reemerge in new areas, implying the increased risk for U. Read More

    Murine models of scrub typhus associated with host control of Orientia tsutsugamushi infection.
    PLoS Negl Trop Dis 2017 Mar 10;11(3):e0005453. Epub 2017 Mar 10.
    Department of Pathology, Center for Biodefense and Emerging Infectious Diseases, Center for Tropical Diseases, Sealy Center for Vaccine Development, Institute of Human Infections and Immunity, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America.
    Background: Scrub typhus, a febrile illness of substantial incidence and mortality, is caused by infection with the obligately intracellular bacterium Orientia tsutsugamushi. It is estimated that there are more than one million cases annually transmitted by the parasitic larval stage of trombiculid mites in the Asia-Pacific region. The antigenic and genetic diversity of the multiple strains of O. Read More

    Healthcare Associated Infections in a Resource Limited Setting.
    J Clin Diagn Res 2017 Jan 1;11(1):OC01-OC04. Epub 2017 Jan 1.
    Professor, Department of Medicine, JIPMER , Puducherry, India .
    Introduction: Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. Read More

    Climate variability, animal reservoir and transmission of scrub typhus in Southern China.
    PLoS Negl Trop Dis 2017 Mar 8;11(3):e0005447. Epub 2017 Mar 8.
    Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China.
    Objectives: We aimed to evaluate the relationships between climate variability, animal reservoirs and scrub typhus incidence in Southern China.

    Methods: We obtained data on scrub typhus cases in Guangzhou every month from 2006 to 2014 from the Chinese communicable disease network. Time-series Poisson regression models and distributed lag nonlinear models (DLNM) were used to evaluate the relationship between risk factors and scrub typhus. Read More

    [Study of epidemic area on Tsutsugamushi disease in Taizhou from 2013 to 2014].
    Zhonghua Yu Fang Yi Xue Za Zhi 2017 Mar;51(3):252-256
    Department of Acute Infectious Disease, Taizhou Center for Disease Prevention and Control, Taizhou 225300, China.
    Objective: To study the epidemiological characteristics of tsutsugamushi disease, and to confirm the existence of the disease's epidemic foci in Taizhou. Methods: From 2013 to 2014, Dongxing town hospital and Xingqiao town hospital were selected as specimen collection sites in Jingjiang city. Blood samples (5 ml) were collected from 40 patients with acute tsutsugamushi disease. Read More

    Molecular characterization of Orientia tsutsugamushi serotypes causing scrub typhus outbreak in southern region of Andhra Pradesh, India.
    Indian J Med Res 2016 Oct;144(4):597-603
    Department of Virology, Sri Venkateswara University, Tirupati, India.
    Background & Objectives: Scrub typhus is a vector-borne zoonotic infection caused by Orientiatsutsugamushi. Local epidemiology of the circulating serotypes of scrub typhus is not available from most parts of India. We conducted this study for the diagnosis of scrub typhus using IgM ELISA and to detect O. Read More

    Clinical Score to Differentiate Scrub Typhus and Dengue: A Tool to Differentiate Scrub Typhus and Dengue.
    J Glob Infect Dis 2017 Jan-Mar;9(1):12-17
    Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
    Background: Dengue and scrub typhus share similar clinical and epidemiological features, and are difficult to differentiate at initial presentation. Many places are endemic to both these infections where they comprise the majority of acute undifferentiated febrile illnesses.

    Materials And Methods: We aimed to develop a score that can differentiate scrub typhus from dengue. Read More

    Diversification of Orientia tsutsugamushi genotypes by intragenic recombination and their potential expansion in endemic areas.
    PLoS Negl Trop Dis 2017 Mar 1;11(3):e0005408. Epub 2017 Mar 1.
    Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.
    Background: Scrub typhus is a mite-borne febrile disease caused by O. tsutsugamushi infection. Recently, emergence of scrub typhus has attracted considerable attention in several endemic countries in Asia and the western Pacific. Read More

    Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam.
    PLoS Negl Trop Dis 2017 Feb 27;11(2):e0005397. Epub 2017 Feb 27.
    URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France.
    Background: Scrub typhus is a rickettsiosis which is caused by Orientia tsutsugamushi and occurs throughout the Asia-Pacific region. Molecular diagnosis of rickettsioses using eschar swabs has recently emerged, and may be very useful for the diagnosis of these diseases in tropical settings.

    Methodology/principal Findings: Quantitative polymerase chain reaction (qPCR) was used to detect O. Read More

    Incidence and Outcome of Acute Cardiorenal Syndrome in Hospitalized Children.
    Indian J Pediatr 2017 Feb 27. Epub 2017 Feb 27.
    Department of Pediatric Medicine, Division of Pediatric Nephrology, SMS Medical College, Jaipur, Rajasthan, 302004, India.
    Objectives: To determine the incidence, etiology and outcome of Cardiorenal syndrome (CRS) in hospitalized children.

    Methods: A prospective cohort study was carried out in 242 children between 6 mo to 18 y of age hospitalized with primary cardiac, renal or any systemic disorder at a tertiary care center in India. The primary outcome was the development of CRS. Read More

    Predictors of acute myocarditis in complicated scrub typhus: an endemic province in the Republic of Korea.
    Korean J Intern Med 2017 Feb 23. Epub 2017 Feb 23.
    Division of Cardiology, Eulji University Hospital, Daejeon, Korea.
    Background/aims: Scrub typhus is known as a self-limited infectious disease. Cardiac complication is uncommon and usually not life-threatening. Until now, few cases of fulminant myocarditis by scrub typhus have been reported. Read More

    Indian Tick Typhus Presenting as Purpura Fulminans with Review on Rickettsial Infections.
    Indian J Dermatol 2017 Jan-Feb;62(1):1-6
    Department of Dermatology, S. S. Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India.
    Rickettsial diseases are some of the most covert reemerging infections of the present times. They are generally incapacitating and notoriously difficult to diagnose; untreated cases can have fatality rates as high as 30%-35%, but when diagnosed properly, they are often easily treated but lack of definite diagnostic tools and the hazards of handling these microorganisms aggravate the difficulties of diagnosis and treatment. Read More

    Use of Multiplex Real-Time PCR To Diagnose Scrub Typhus.
    J Clin Microbiol 2017 May 15;55(5):1377-1387. Epub 2017 Feb 15.
    Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
    Scrub typhus, caused by Orientia tsutsugamushi, is a common cause of acute undifferentiated febrile illness in the Asia-Pacific region. However, its nonspecific clinical manifestation often prevents early diagnosis. We propose the use of PCR and serologic tests as diagnostic tools. Read More

    Molecular detection of Orientia tsutsugamushi from suspected scrub typhus cases.
    Indian J Pathol Microbiol 2017 Jan-Mar;60(1):70-73
    Department of Microbiology, Dr. A. L. Mudaliar PG Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, Tamil Nadu, India.
    Context: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The disease is under-diagnosed in India, because of low index of suspicion and also due to its nonspecific presentation, and lack of confirmatory diagnostic tests.

    Aims: This study was undertaken to diagnose scrub typhus in patients with undifferentiated fevers by serology and molecular methods. Read More

    Prevalence and clinical presentation of Rickettsia, Coxiella, Leptospira, Bartonella and chikungunya virus infections among hospital-based febrile patients from December 2008 to November 2009 in Bangladesh.
    BMC Infect Dis 2017 Feb 13;17(1):141. Epub 2017 Feb 13.
    International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
    Background: We conducted a study to identify Rickettsia, Coxiella, Leptospira, Bartonella, and Chikungunya virus infections among febrile patients presenting at hospitals in Bangladesh.

    Methods: We collected blood samples from patients at six tertiary hospitals from December 2008 to November 2009 and performed laboratory tests at the United States Centers for Disease Control and Prevention (CDC).

    Results: Out of 720 enrolled patients, 263 (37%) were infected with Rickettsia; 132 patients had immunofluorescence antibody titer >64 against spotted fever, 63 patients against scrub typhus fever and 10 patients against typhus fever. Read More

    Prevalence and risk factors for scrub typhus in South India.
    Trop Med Int Health 2017 Feb 7. Epub 2017 Feb 7.
    Christian Medical College, Vellore, India.
    Objective: To determine the prevalence and risk factors of scrub typhus in Tamil Nadu, South India.

    Methods: We performed a clustered seroprevalence study of the areas around Vellore. All participants completed a risk factor survey, with seropositive and seronegative participants acting as cases and controls, respectively, in a risk factor analysis. Read More

    Epidemiological profile of acute respiratory distress syndrome patients: A tertiary care experience.
    Lung India 2017 Jan-Feb;34(1):38-42
    Department of Anaesthesiology, Dharwad Institute of Mental Health and Neurosciences, Dharwad, Karnataka, India.
    Background: Acute respiratory distress syndrome (ARDS) is seen in critically ill patients. Its etiological spectrum in India is expected to be different from that seen in western countries due to the high prevalence of tropical infections.

    Aim: To study the epidemiological profile of ARDS patients. Read More

    Retrospective survey of severe fever with thrombocytopenia syndrome in patients with suspected rickettsiosis in Japan.
    J Infect Chemother 2017 Jan 26;23(1):45-50. Epub 2016 Oct 26.
    Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan. Electronic address:
    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). The aim of this study was to clarify whether SFTS is potentially mis-diagnosed as rickettsioses, including spotted fever, typhus fever, and scrub typhus, which are also tick-borne disease. A total of 464 serum samples collected from 222 patients with clinically suspected rickettsiosis between 1999 and 2012 were tested for antibodies against the SFTSV. Read More

    Successfully Managed Acute Transverse Myelitis Related to Scrub Typhus and Serial Image Findings.
    Am J Trop Med Hyg 2017 Jan 23. Epub 2017 Jan 23.
    Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
    Central nervous system involvement manifesting as meningitis or meningoencephalitis is a known complication of scrub typhus, but very few spinal cord lesions such as acute transverse myelitis (ATM) have been reported in association with this disease. Scrub typhus patients with a spinal lesion present with neurologic symptoms including dysuria, motor, and sensory weakness. Herein, we describe a rare case of ATM associated with scrub typhus. Read More

    Orientia tsutsugamushi Ank9 is a multifunctional effector that utilizes a novel GRIP-like Golgi localization domain for Golgi-to-endoplasmic reticulum trafficking and interacts with host COPB2.
    Cell Microbiol 2017 Jan 19. Epub 2017 Jan 19.
    Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
    Orientia tsutsugamushi causes scrub typhus, a potentially fatal infection that afflicts 1 million people annually. This obligate intracellular bacterium boasts one of the largest microbial arsenals of ankyrin repeat-containing protein (Ank) effectors, most of which target the endoplasmic reticulum (ER) by undefined mechanisms. Ank9 is the only one proven to function during infection. Read More

    Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents.
    Kidney Int 2017 May 11;91(5):1033-1046. Epub 2017 Jan 11.
    George Institute for Global Health, New Delhi, India, and University of Oxford, Oxford, UK.
    South and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. Read More

    Genotypic characterization of Orientia tsutsugamushi from patients in two geographical locations in Sri Lanka.
    BMC Infect Dis 2017 Jan 13;17(1):67. Epub 2017 Jan 13.
    Department of Medicine, Faculty of Medicine, University of Kelaniya, Thalagolla Road, PO Box 6, Ragama, Sri Lanka.
    Background: To date more than 20 antigenically distinct strains of Orientia tsutsugamushi (OT) reported within the tsutsugamushi triangle that cause an undifferentiated acute febrile illness in humans. Genotypic characterization of OT in different geographic regions or within the same country, is important in order to establish effective diagnostics, clinical management and to develop effective vaccines. Genetic and antigenic characterization of OT causing human disease in OT-endemic regions is not known for Sri Lanka. Read More

    Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014.
    BMC Infect Dis 2017 Jan 5;17(1):13. Epub 2017 Jan 5.
    The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
    Background: In the last decade, scrub typhus (ST) has been emerging or re-emerging in some areas of Asia, including Guangzhou, one of the most affected endemic areas of ST in China.

    Methods: Based on the data on all cases reported in Guangzhou from 2006 to 2014, we characterized the epidemiological features, and identified environmental determinants for the spatial distribution of ST using a panel negative binomial model.

    Results: A total of 4821 scrub typhus cases were reported in Guangzhou during 2006-2014. Read More

    Evaluation of a broad-ranging and convenient enzyme-linked immunosorbent assay using the lysate of infected cells with five serotypes of Orientia tsutsugamushi, a causative agent of scrub typhus.
    BMC Microbiol 2017 Jan 5;17(1). Epub 2017 Jan 5.
    Department of Virology 1, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
    Background: Scrub typhus is a mite-borne rickettsiosis caused by infection of Orientia tsutsugamushi, which is endemic to several Asia-Pacific Rim countries, including Japan. Although micro-indirect immunofluorescent assay (micro-IFA) is the standard method for the serological diagnosis of scrub typhus, enzyme-linked immunosorbent assay (ELISA) is considered to be more objective, by providing digitized results as opposed to being subject to the judgment of the evaluator as in micro-IFA. Therefore, the aim of this study was to develop a broad-ranging ELISA using the five major prevalent serotypes of O. Read More

    Differences in Clinical and Laboratory Features for Different Genotypes of Orientia tsutsugamushi in Guangzhou, Southern China.
    Vector Borne Zoonotic Dis 2017 Apr 5;17(4):260-267. Epub 2017 Jan 5.
    Guangzhou Center for Disease Control and Prevention , Guangzhou, China .
    Purpose: To describe the genotypes distribution of Orientia tsutsugamushi, in Guangzhou, and explore differences in clinical and laboratory features among genotypes.

    Method: We collected blood or eschar samples of all scrub typhus cases reported in 2013 from 10 district hospitals positive for PCR. We further tested the PCR-positive samples for DNA sequencing and phylogenetic analysis. Read More

    Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests.
    J Clin Diagn Res 2016 Nov 1;10(11):DC07-DC10. Epub 2016 Nov 1.
    Teaching Faculty, Department of Microbiology, Hallym University College of Medicine , Chuncheon, Gangwon do, South Korea .
    Introduction: Scrub Typhus (ST) is being reported from different parts of India in the recent past. However, the diagnosis and confirmation of ST cases require specific serological and molecular diagnostic tests. Both rapid and conventional ELISA tests need to be properly evaluated. Read More

    Scrub typhus: radiological and clinical findings in abdominopelvic involvement.
    Jpn J Radiol 2017 Mar 2;35(3):101-108. Epub 2017 Jan 2.
    Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea.
    Purpose: To describe the clinical and radiological findings of abdominopelvic involvement in scrub typhus.

    Materials And Methods: Abdominopelvic computed tomography (CT) of 78 patients with scrub typhus were evaluated by two readers. The presence of gallbladder wall thickening, arterial inhomogeneous enhancement of the liver, periportal edema, splenic infarction, hepatomegaly, splenomegaly, ascites, pleural effusion, and sites of lymphadenopathy were evaluated. Read More

    Characteristics of Pediatric Scrub Typhus Eschar in South Indian Children.
    Pediatr Dermatol 2017 Mar 16;34(2):124-127. Epub 2016 Dec 16.
    Pediatrics, Indira Gandhi Medical College and Research Institute (IGMC&RI), Puducherry, India.
    Background: Knowledge of anatomic location of eschar is useful in diagnosing scrub typhus early in children and to initiate appropriate treatment.

    Methods: All children younger than 12 years of age admitted with confirmed diagnosis of scrub typhus over a 17-month period were included and the presence of eschar and other characteristics were recorded and analyzed.

    Results: Of 107 confirmed patients with scrub typhus, 37 (34. Read More

    The Epidemiology and Characteristics of Q fever and Co-infections with Scrub Typhus, Murine Typhus or Leptospirosis in Taiwan: A Nationwide Database Study.
    Zoonoses Public Health 2016 Dec 14. Epub 2016 Dec 14.
    Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
    Q fever (QF) is a worldwide zoonosis associated with outbreaks. Only a few nationwide studies regarding the surveillance and epidemiology of human QF have been reported. Although QF is endemic in Taiwan, a nationwide database investigation of the epidemiology and characteristics of QF and its associations with scrub typhus (ST), murine typhus (MT) and leptospirosis (LS) has never been reported. Read More

    Acute Undifferentiated Febrile Illness in Patients Presenting to a Tertiary Care Hospital in South India: Clinical Spectrum and Outcome.
    J Glob Infect Dis 2016 Oct-Dec;8(4):147-154
    Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
    Background: Acute undifferentiated febrile illness (AUFI) may have similar clinical presentation, and the etiology is varied and region specific.

    Materials And Methods: This prospective observational study was conducted in a tertiary hospital in South India. All adult patients presenting with AUFI of 3-14 days duration were evaluated for etiology, and the differences in presentation and outcome were analyzed. Read More

    A Cost-Effective Approach to the Diagnosis and Management of Acute Infectious Encephalitis.
    Eur Neurol 2017 8;77(1-2):66-74. Epub 2016 Dec 8.
    Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
    Setting: A tertiary care teaching hospital in India.

    Objective: To report a syndromic approach to acute encephalitis syndrome (AES) and propose a cost-effective model.

    Study Design: AES patients were categorized by the presence or absence of myalgia/rash into systemic and neurological AES. Read More

    Generation of protective immunity against Orientia tsutsugamushi infection by immunization with a zinc oxide nanoparticle combined with ScaA antigen.
    J Nanobiotechnology 2016 Nov 26;14(1):76. Epub 2016 Nov 26.
    Department of Microbiology and Immunology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
    Background: Zinc oxide nanoparticle (ZNP) has been applied in various biomedical fields. Here, we investigated the usage of ZNP as an antigen carrier for vaccine development by combining a high affinity peptide to ZNP.

    Results: A novel zinc oxide-binding peptide (ZBP), FPYPGGDA, with high affinity to ZNP (K a  = 2. Read More

    Scrub Typhus: An Emerging Neglected Tropical Disease in Nepal.
    J Nepal Health Res Counc 2016 May;14(33):122-127
    Epidemiology and Disease Control Division, Department of Health Services, Nepal.
    Background: Scrub typhus is a neglected tropical disease and is under reported from Nepal. The objective of this study was to investigate the sero-epidemiology of scrub typhus in patients suffering from acute febrile illness.

    Methods: A total of 434 specimens collected from July to November 2015 at National Public Health Laboratory (NPHL) were investigated for detection of immunoglobulin M (IgM) antibody to Orientiatsutsugamushi. Read More

    Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection.
    Infect Chemother 2016 Dec 8;48(4):330-333. Epub 2016 Nov 8.
    Division of Infectious Diseases, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
    There have been a small number of cases of scrub typhus-associated hemophagocytic syndrome (HPS), most of which were treated successfully using adequate antibiotics. Here, we report a case of Epstein-Barr virus (EBV)-associated HPS after scrub typhus infection that was not improved using antirickettsial treatment. A 73-year-old male who had been diagnosed with scrub typhus according to an eschar and a positive serology was transferred to our institution because of a persistent fever despite 7-day doxycycline therapy. Read More

    Scrub Typhus Leading to Acute Encephalitis Syndrome, Assam, India.
    Emerg Infect Dis 2017 Jan 15;23(1):148-150. Epub 2017 Jan 15.
    To determine the contribution of Orientia tsutsugamushi, the agent of scrub typhus, as a cause of acute encephalitis syndrome (AES) in Assam, India, we conducted a retrospective study of hospital patients with symptoms of AES during 2013-2015. Our findings suggest that O. tsutsugamushi infection leads to AES and the resulting illness and death. Read More

    Epidemiology & risk factors of scrub typhus in south India.
    Indian J Med Res 2016 Jul;144(1):76-81
    Department of Community Health, Christian Medical College & Hospital, Vellore, India.
    Background & Objectives: Scrub typhus is a major public health threat in South and Southeastern Asian countries including India. Understanding local patterns of disease and factors that place individuals at risk is pivotal to future preventive measures against scrub typhus. The primary aim of this study was to identify specific epidemiological and geographical factors associated with an increased risk of developing scrub typhus in this region. Read More

    Scrub typhus in pregnancy: Maternal and fetal outcomes.
    Obstet Med 2016 Dec 5;9(4):164-166. Epub 2016 May 5.
    Department of Medicine Unit 1, Christian Medical College, Vellore, India.
    Scrub typhus is an important unrecognized cause for undifferentiated acute febrile illness in India associated with poor fetal outcomes. Maternal and fetal outcomes among pregnant patients with scrub typhus presenting to a tertiary care university teaching hospital from January 2010 to July 2012 were studied. Scrub typhus was diagnosed by clinical criteria along with scrub ELISA positivity or an eschar. Read More

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