Scrub typhus is an acute febrile illness, which was caused by Orientia tsutsugamushi and transmitted through the bite of chiggers. The diagnosis ...SkiptomaincontentAdvertisementSearchallBMCarticlesSearchDownloadPDFCasereportOpenAccessPublished:07April2020Diagnosisofseverescrubtyphusinfectionbynext-generationsequencing:acasereportJieChen1,Xu-dongZheng1,Qi-heDai1,Wei-liHong1,You-pengLi1,RuiChen1,Bing-bingYe1,Xiao-jieMo1,PengCui2&Zhan-weiRuan1 BMCInfectiousDiseasesvolume 20,Article number: 270(2020)Citethisarticle1001Accesses3CitationsMetricsdetailsAbstractBackgroundScrubtyphusisanacutefebrileillness,whichwascausedbyOrientiatsutsugamushiandtransmittedthroughthebiteofchiggers.Thediagnosisofscrubtyphuscouldbemisseddiagnosisduetotheabsenceofthepathognomoniceschar.CasepresentationA76-year-oldmanwashospitalizedwithfeverandkidneyinjuryandwasdiagnosedofhemorrhagicfeverwithrenalsyndromefirst.However,thesituationoftheillnessdeterioratedintorefractorysepticshockandmultipleorgandysfunctionrapidly,althoughthetreatmentofanti-sepsiswasusedin3rd-5thday.OrientiatsutsugamushiwasdeterminedtobethecausativepathogenbyNext-generationsequencingofhisplasmasamplein6thday.Then,thepatientwastreatedwithdoxycyclineandazithromycinandrecoveredquickly.ConclusionsNext-generationsequencingwasanewdiagnostictechnologyandcouldidentifyscrubtyphusinaccuratelyandfastwithoutthepathognomoniceschar.PeerReviewreportsBackgroundScrubtyphusisanacutefebrileillnesscausedbyOrientiatsutsugamushi(agram-negativecoccobacillus)andtransmittedthroughthebiteofchiggers[1].Themortalityofscrubtyphusisreportedtobeashighas24%inseverecaseswithmultipleorgandysfunction(MODS)[2].Thediagnosisofscrubtyphusisdifficultduetotheabsenceofthepathognomoniceschar,whichisthecharacteristicclinicalmanifestationsandvarieswidely(3–93%)[1].Serology,biopsy,culture,andpolymerasechain(PCR)reactionwereroutinediagnosticmethodsandhadmanydefectsinthediagnosis[3].Forexample,theindirectfluorescentantibodytestneedsafour-foldriseintitersovera14-dayperiod[4].Po