Wang Zhiguang, Piao Yuhua, An Zhongjian, Piao Hongmei
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yanbian University, Yanji, China.
BMC Pulm Med. 2025 Jul 12;25(1):340. doi: 10.1186/s12890-025-03827-2.
Scrub typhus is an acute febrile illness caused by the rickettsial bacterium Orientia tsutsugamushi, transmitted to humans through infected mite bites. Patients typically present with sudden onset high fever, headache, myalgia, and eschar formation at the site of the bites. Respiratory symptoms, such as cough and shortness of breath, can also occur, especially in severe cases that lead to pneumonia or acute respiratory distress syndrome (ARDS). This report presents a case of scrub typhus pneumonia, diagnosed by metagenomic next-generation sequencing (mNGS) on bronchoalveolar lavage fluid(BALF).
A 58-year-old woman was admitted with cough, sputum production, and fever. Imaging revealed pneumonia. During hospitalization, bronchoscopy was performed to identify the causative pathogen. mNGS of the bronchoalveolar lavage fluid confirmed Orientia tsutsugamushi infection. Patient's pneumonia was improved after oral administration of doxycycline(100 mg two times daily) for 1 month.
This report highlights the diagnostic challenges of scrub typhus-induced pneumonia and demonstrates usefulness and the advantages of mNGS in identifying rare pathogens.
恙虫病是由立克次体细菌恙虫病东方体引起的急性发热性疾病，通过受感染的螨虫叮咬传播给人类。患者通常表现为突然高热、头痛、肌痛以及叮咬部位出现焦痂。还可能出现咳嗽和呼吸急促等呼吸道症状，尤其是在导致肺炎或急性呼吸窘迫综合征（ARDS）的严重病例中。本报告介绍了一例通过支气管肺泡灌洗（BALF）的宏基因组下一代测序（mNGS）诊断出的恙虫病肺炎病例。
一名58岁女性因咳嗽、咳痰和发热入院。影像学检查显示为肺炎。住院期间，进行了支气管镜检查以确定病原体。支气管肺泡灌洗的mNGS证实了恙虫病东方体感染。口服多西环素（每日两次，每次100mg）1个月后，患者的肺炎病情有所改善。
本报告突出了恙虫病所致肺炎的诊断挑战，并证明了mNGS在识别罕见病原体方面的实用性和优势。
