Department of Emergency, Third Affiliated Hospital, Wenzhou Medical University, 108 Wansong Road, Zhejiang, 325200, China.
BGI-Shanghai, Kangxin Rd, Pudong District, Shanghai, 201321, Guangdong, China.
BMC Infect Dis. 2020 Apr 7;20(1):270. doi: 10.1186/s12879-020-04991-y.
Scrub typhus is an acute febrile illness, which was caused by Orientia tsutsugamushi and transmitted through the bite of chiggers. The diagnosis of scrub typhus could be missed diagnosis due to the absence of the pathognomonic eschar.
A 76-year-old man was hospitalized with fever and kidney injury and was diagnosed of hemorrhagic fever with renal syndrome first. However, the situation of the illness deteriorated into refractory septic shock and multiple organ dysfunction rapidly,although the treatment of anti-sepsis was used in 3rd-5th day. Orientia tsutsugamushi was determined to be the causative pathogen by Next-generation sequencing of his plasma sample in 6th day. Then, the patient was treated with doxycycline and azithromycin and recovered quickly.
Next-generation sequencing was a new diagnostic technology and could identify scrub typhus in accurately and fast without the pathognomonic eschar.
恙虫病是一种由恙虫东方体引起的急性发热性疾病，通过恙螨幼虫叮咬传播。由于缺乏特征性焦痂，恙虫病的诊断可能会被漏诊。
一名 76 岁男性因发热和肾损伤住院，最初被诊断为肾综合征出血热。然而，尽管在第 3-5 天使用了抗脓毒症治疗，病情迅速恶化为难治性感染性休克和多器官功能障碍。第 6 天通过对患者血浆样本进行下一代测序，确定恙虫东方体为病原体。然后，患者接受多西环素和阿奇霉素治疗，病情迅速恢复。
下一代测序是一种新的诊断技术，即使没有特征性焦痂，也可以快速准确地识别恙虫病。
