Department of Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China.
Western Reserve Academy 115 College Street, Hudson, OH 44236, United States.
Int J Infect Dis. 2020 Jan;90:1-4. doi: 10.1016/j.ijid.2019.10.020. Epub 2019 Oct 21.
Scrub typhus is caused by Orientia tsutsugamushi. Clinical manifestations include fever, rash, eschar at the bite site, and other non-specific flu-like symptoms. The eschar is a dark, scab-like area at the bite site, and is the typical lesions that prompts a diagnosis of O. tsutsugamushi. Without eschar lesions, it is difficult to identify scrub typhus. However, metagenomic next-generation sequencing (mNGS) can be used to identify infections, and this novel method may help improve clinical diagnosis.
Here, we report a case of scrub typhus in a 51-year-old woman who presented to the emergency department with a week-long fever from an unknown cause. We used mNGS to search for an infectious etiology, and the mNGS suggested O. tsutsugamushi, which was unexpectedly detected.
This study suggests that mNGS may be a useful diagnostic tool to identify clinical, causative pathogens in fever, particular ones with atypical features.
恙虫病是由恙虫东方体引起的。临床表现包括发热、皮疹、叮咬部位的焦痂以及其他非特异性流感样症状。焦痂是叮咬部位的暗褐色痂皮样区域，是提示东方体感染的典型病变。没有焦痂病变，很难诊断恙虫病。然而，宏基因组下一代测序（mNGS）可用于识别感染，这种新方法可能有助于提高临床诊断。
这里，我们报告了一例 51 岁女性恙虫病病例，她因不明原因发热一周而到急诊科就诊。我们使用 mNGS 寻找感染病因，mNGS 提示恙虫东方体，意外地检测到了该病原体。
本研究表明，mNGS 可能是一种有用的诊断工具，可用于识别发热患者中的临床致病病原体，特别是那些具有非典型特征的病原体。
