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scrub typhus; Japanese river fever

Etiology: - Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi) Epidemiology: 1) endemic in South Pacific, Australia, Asia 2) transmitted by trombiculid mites, also known as chiggers Clinical manifestations: - fever prior to rash (case report) [2] - diffuse maculopapular skin eruption starting on the trunk - eschar at site of mite bite - headaches - myalgias - regional adenopathy * images [2] Complications: - untreated mortality up to 30% Management: - doxycycline 100 mg PO BID for 7 days [2] - see Rocky Mountain spotted fever

Related

eschar Orientia tsutsugamushi (Rickettsia tsutsugamushi) Trombiculidae (chigger mite)

General

typhus

References

  1. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 91
  2. Lee CS, Hwang JH (images) Scrub Typhus. N Engl J Med 2015; 373:2455. December 17, 2015 PMID: 26672847 http://www.nejm.org/doi/full/10.1056/NEJMicm1503639