Scrub typhus is an acute undifferentiated febrile infectious disease transmitted by a chigger(genus Leptotrombidium)bite carrying Orientia(O.)tsutsugamushi,affecting millions of people annually while more than one bil...Scrub typhus is an acute undifferentiated febrile infectious disease transmitted by a chigger(genus Leptotrombidium)bite carrying Orientia(O.)tsutsugamushi,affecting millions of people annually while more than one billion people are susceptible.Endemic areas are expanding to Africa,Europe,Middle East,and South America which is concerning,as despite best efforts,there is no vaccine to combat the bacteria.There are now three species of Orientia and over 20 strains of O.tsutsugamushi.The past attempts to develop a vaccine have been ineffective as they confer homologous strain-specific immunity.Various immunogenic proteins of O.tsutsugamushi have been identified that interact with the extracellular matrix(fibronectin)or vMLL5 receptor and modify the cytoskeleton of non-phagocytic host cells,which aids in host cell adhesion and invasion.These highly conserved proteins involve type specific antigen 56(TSA56),47 kDa,OmpA,and autotransporter proteins(ScaA,ScaB and ScaC).TSA56 is the most immunogenic and contains four types of hypervariable regions.Out of all autotransporter proteins,ScaA provides the homologous strains specific immunity and when coupled with TSA56 it shows better protective immunity against heterologous strains.The review provides detailed insight into the potential immunogenic proteins of Orientia which can be utilized to develop the vaccine.Furthermore,studies focused on highly antigenic proteins will provide more insight into their roles in developing therapeutics and easy-to-handle rapid diagnostic kits.展开更多
This article summarizes the nursing management of a pediatric patient with severe scrub typhus complicated by hemophagocytic syndrome(HPS)and septic shock.Key nursing interventions included early recognition and manag...This article summarizes the nursing management of a pediatric patient with severe scrub typhus complicated by hemophagocytic syndrome(HPS)and septic shock.Key nursing interventions included early recognition and management of septic shock,rational oxygen therapy,fluid resuscitation,administration of vasoactive agents,early and targeted anti-infective therapy,management of hyperpyrexia,care of eschar and edematous skin,strict infection prevention and isolation protocols,and family health education.After 11 days of intensive treatment and nursing care,the patient recovered and was discharged.展开更多
Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Se...Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Services,Kerala.136 Of serologically confirmed scrub typhus reported during 2018 were included and 270 age and sex-matched healthy controls were selected randomly from different locations in the same area where the cases were reported.The risk factors identified were compared between cases and controls,using univariate and multivariable logistic regression analysis to identify the risk factors for scrub typhus infection.Results:Some key factors like house type with individuals residing in houses with concrete roofs are associated with a higher risk of scrub typhus infection compared to tiled roofs(aOR 0.14,95%CI 0.36-0.56,P=0.005).Housewives exhibit a significantly higher risk(aOR 3.97,95%CI 2.15-8.94,P=0.038)of scrub typhus infection.Environmental factors,including the presence of rats(aOR 3.48,95%CI 1.19-6.53,P=0.023),the presence of domestic animals(aOR 2.98,95%CI 1.67-5.19,P<0.001),wet agricultural fields around the house(aOR 3.64,95%CI 1.50-6.54,P<0.001),and hygiene practices like not changing clothes after work(aOR 2.64,95%CI 1.37-4.68,P=0.024),and disposing of the wastes in their own yard(aOR 4.79,95%CI 3.78-9.55,P=0.043)are identified as significant high-risk factors for scrub typhus infection.Conclusions:These findings will be very useful to create awareness among the public and to undertake a detailed control strategy for scrub typhus.展开更多
Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagno...Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagnosis is often missed because of similarities with oilier tropical febrile infections.Many unusual manifestations are present,and these are described in this review,together with an outline of current knowledge of pathophysiology.Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis,resulting in early administration of appropriate antibiotics.Prognostic indicators for severe disease have not yet been clearly established.展开更多
Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombin...Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombinant 56-kDa proteins of O.tsutsugamushi and mIFA assay were performed on 20 patients from Fujian and 13 patients from Yunnan Province,and 82 sera samples from healthy farmers in Anhui Province and Beijing City in 2009.Comparison of the RDT and mIFA assay was performed by using X test and the P level of 【0.05 was considered to be significance.Results:Among these 82 normal sera samples,the specificity of RDT was 100%for both IgM and IgG tests.In 33 samples from patients with scrub typhus,5 cases were positively detected earlier by RDT than by mIFA in IgM test,and 2 cases were positive in IgG test.Sensitivities of RDT were 93.9%and 90.9%for IgM and IgG,respectively.The sensitivity of combination lest of IgM and IgG was 100%.Geometric mean titer diluted sera from confirmed cases by IFA and RDT assay were 1:37 vs.1:113(P【0.001) in IgM test and 1:99 vs.1:279 (P【0.05) in IgG test.Conclusions:RDT is more sensitivite than mIFA in the early diagnosis of scrub typhus and it is particularly applicable in rural areas.展开更多
The zone of alpine scrub and meadow, characterized by highlandsubpolar humid/subhumid climate, is a transitional area from deep gorges to theplateau proper.The natural zone is unique in physical environments and natur...The zone of alpine scrub and meadow, characterized by highlandsubpolar humid/subhumid climate, is a transitional area from deep gorges to theplateau proper.The natural zone is unique in physical environments and naturalecosystems, and could not be found at the lowlands elsewhere on the earth.Thepredominant type of vegeation is alpine meadow, including Kobresia meadow,herbaceous meadow and swampy meadow. It is an important pasturelands ofanimal husbandry for Tibetan on the plateau. Main vegetion types, animal groups,characteristics of alpine meadow soils, the altitudinal belt and the horizontalzonality of the natural zone, as well as utilization and management of the grasslandsare discussed in the present paper.展开更多
Wet purification technology for nonferrous metal smelting flue gas is important for mercury removal;however, this technology produces a large amounts of spent scrubbing solution that contain mercury. The mercury in th...Wet purification technology for nonferrous metal smelting flue gas is important for mercury removal;however, this technology produces a large amounts of spent scrubbing solution that contain mercury. The mercury in these scrubbing solutions pose a great threat to the environment. Therefore, this research provides a novel strategy for removing and recycling mercury from the scrubbing solution, which is significant for decreasing mercury pollution while also allowing for the safe disposal of wastewater and a stable supply of mercury resources. Some critical parameters for the electrochemical reduction of mercury were studied in detail. Additionally, the electrodeposition dynamics and electroreduction mechanism for mercury were evaluated. Results suggested that over 92.4% of mercury could be removed from the scrubbing solution in the form of a Hg-Cu alloy under optimal conditions within 150 min and with a current efficiency of approximately 75%. Additionally, mercury electrodeposition was a quasi-reversible process, and the controlled step was the mass transport of the reactant. A pre-conversion step from Hg(Tu)_(4)^(2+) to Hg(Tu)_(3)^(2+) before mercury electroreduction was necessary. Then, the formed Hg(Tu)_(3)^(2+) on the cathode surface gained electrons step by step. After electrodeposition, the mercury in the spent cathode could be recycled by thermal desorption. The results of the electrochemical reduction of mercury and subsequent recycling provides a practical and easy-to-adopt alternative for recycling mercury resources and decreasing mercury contamination.展开更多
Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years o...Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with periopancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.展开更多
Scrub typhus is a neglected disease and one of the most serious health problems in the Asia-Pacific region.The disease is caused by an obligate intracellular bacteria Orientia tsutsugamushi,which is transmitted by chi...Scrub typhus is a neglected disease and one of the most serious health problems in the Asia-Pacific region.The disease is caused by an obligate intracellular bacteria Orientia tsutsugamushi,which is transmitted by chigger bites or larval mite bites.Scrub typhus is a threat to billions of people worldwide causing different health complications and acute encephalitis in infants and growing children.The disease causes multiple organ failure and mortality rates may reach up to 70%due to a lack of appropriate healthcare.Currently available genome and proteome databases,and bioinformatics methods are valuable tools to develop novel therapeutics to curb the pathogen.This review discusses the state-of-the-art of information about Orientia tsutsugamushi-mediated scrub typhus and delineates the role of omics technologies to develop drugs against the pathogen.The role of proteome-wide in silico approaches for the identification of therapeutic targets is also highlighted.展开更多
Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was defi...Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by his- topathological examination of liver biopsy specimens, serological tests and nested polymerase chain reaction. Immunohistochemical staining using a monoclonal an- ti-O. tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes. This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis. Thus, scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses, which causes severe Iobular disarray with diffuse hepatocytic degeneration, necrosis and apoptosis as well as findings indicative of hepatic cholestasis, such as hepatic bile plugs or brown pigmentation of hepatocytes.展开更多
Objective:To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods:This was a prospective observational cohort study conduc...Objective:To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods:This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER,Chandigarh,India.One hundred and twenty-six patients aged≥13 years were diagnosed with scrub typhus.Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment(SOFA)score on admission.Results:About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt.Fever(99.21%)and dyspnea(79.36%)were the most frequent complaints.Respiratory failure(81.75%)was the most common organ failure,followed by hepatic(52.38%),coagulative(47.62%),circulatory(33.33%),renal(21.43%),and cerebral dysfunction(13.49%).The median(Q1,Q3)SOFA score was 8(6,9),and 48.41%of the patients had a quick-SOFA score≥2.Organ supports with invasive ventilation(40.48%),vasopressors(36.51%),and renal replacement therapy(7.14%)were frequently required.The in-hospital mortality was 11.90% and was independently predicted by circulatory and hepatic failures on multivariate logistic regression(OR 11.12,95%CI 1.73-71.31 and OR 8.49,95%CI 1.18-61.41,respectively).Conclusions:Most patients had pulmonary dysfunction;circulatory or hepatic failure on admission strongly predicts death.展开更多
A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple sm...A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy.Despite intensive therapy,the massive hematochezia worsened and the distal small bowel was resected.Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus.This is the first reported case of pathologically proven small bowel involvement in scrub typhus infection.展开更多
Biogas is a kind of regenerable energy which is inexpensive and friendly to the environment, but the potential ofbiogas is difficult to develop fully in China, for most biogas have badly qualities and the utilization ...Biogas is a kind of regenerable energy which is inexpensive and friendly to the environment, but the potential ofbiogas is difficult to develop fully in China, for most biogas have badly qualities and the utilization of it is monotonous. The suitable operation term about biogas upgrading by pressurized water scrubbing was researched through the orthogonal test in this study. Two sorts of scrubber packing included the random multidimensional hollow sphere packing and the structured screen packing were also used, and the effects of experiment factors included packing, water temperature, gas flow speed, water flow speed and washing pressure were studied. The results showed that better effect was got when the screen structured packing was used; all the five test factors affected the processing significantly in the arrange as before and had better and better significant effects.展开更多
Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female pres...Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.展开更多
Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult p...Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice.展开更多
BACKGROUND Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi(O.tsutsugamushi).Omadacycline,a ...BACKGROUND Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi(O.tsutsugamushi).Omadacycline,a novel tetracycline,exhibits potent antibacterial efficacy against both typical bacteria and atypical pathogens.However,omadacycline application in the treatment of scrub typhus remains limited.CASE SUMMARY In the present work,we report several cases of scrub typhus,with the main clinical symptoms being fever,the formation of eschars or ulcers,local or systemic lymphadenopathy,headache,myalgia and rash.Blood samples were collected before omadacycline was administered,and O.tsutsugamushi infection was confirmed through targeted next-generation sequencing(tNGS).After two days of treatment,the patients’symptoms,including fever,were alleviated,with no adverse drug reactions.CONCLUSION tNGS is an effective method for diagnosing scrub typhus.Omadacycline can be considered an alternative option for antiinfective therapy in patients with O.tsutsugamushi infections.展开更多
Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus betw...Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022.Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody.The data about demography,vital parameters,and lab investigations were collected and analyzed.Results:Ninety-two percent of the patients were from a rural background(92%),86% were farmers and the majority were females.Most patients were 40-60 years old.The major complaints were fever(100%),myalgia(100%),headache(82%),and body swelling(80%).Major complications were pneumonia(68%),multiple organ dysfunction syndrome(62%),hepatitis(44%),and acute kidney injury(42%).Triglyceride levels were>200 mg/dL in 80% of patients,albumin<3.5 g/dL in 98% and eschar mark was present in 24%of patients.Conclusions:Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality.Increasing awareness regarding disease in endemic regions,early screening of patients,and treatment as early as possible could help prevent the patient from severe life-threatening complications.展开更多
The present study was undertaken to determine the variability in fiber cell morphology and its length among wood species of the Tamaulipan Thorn Scrub, Northeastern Mexico, used for various uses such as timber for fur...The present study was undertaken to determine the variability in fiber cell morphology and its length among wood species of the Tamaulipan Thorn Scrub, Northeastern Mexico, used for various uses such as timber for furniture, fence, post, firewood and sources of forage. The results reveal large variability in fiber cell morphology and fiber cell dimensions. The species are classified on the basis of its fiber cell morphology and fiber cell length and recommended for their possible utilization for different purposes. Wood having fibre cells with broad lumen and thin wall could be suitable for the manufacture of paper documented in the literature viz. Acacia farnesciana, Caesalpinia mexicana, Cordia boisiieri, Diospyros palmeri, Forestieria angustifolia, Morus celtifolia, Prosopis laevigata. This technique can be used in preliminary screening of woody species for its utilization for different purposes. Further studies are needed to confirm.展开更多
AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes.METHODS Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and dia...AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes.METHODS Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio(OR) with 95%CI.RESULTS The cohort(n = 81; 35 males) aged 49.4 ± 16.1 years(mean, SD) presented 8.1 ± 3.1 d after symptom onset. The APACHE-Ⅱ score was 15.7 ± 7.0. Fortyeight (59%) patients were ventilated, and 46 (56%) required vasoactive agents. Mortality was 9.9%. ECG changes were non-specific; sinus tachycardia was the most common finding. Myocardial injury was evident in 61.7% of patients and LV systolic dysfunction in 30.9%. A diagnosis of myocarditis was made in 12.3%. In addition, seven patients with regional wall motion abnormalities had LV systolic dysfunction and elevated cardiac enzymes. Mild diastolic dysfunction was observed in 18 (22%) patients. Mild to moderate pericardial effusion was seen in 51%. On multivariate logistic regression analysis, patients with myocarditis tended to be older (OR = 1.04, 95%CI: 0.99-1.09), had shorter symptom duration (OR = 0.69, 95%CI: 0.49-0.98), and tended to stay longer in hospital(OR = 1.17, 95%CI: 0.98-1.40). Myocarditis was not associated with increased mortality.CONCLUSION In scrub typhus infection, cardiac manifestations are frequent and associated with increased morbidity but not mortality.展开更多
基金funded by Department of Health Research,Government of India,New Delhi,India(grant number:YSS/2020/000116/PRCYSS).
文摘Scrub typhus is an acute undifferentiated febrile infectious disease transmitted by a chigger(genus Leptotrombidium)bite carrying Orientia(O.)tsutsugamushi,affecting millions of people annually while more than one billion people are susceptible.Endemic areas are expanding to Africa,Europe,Middle East,and South America which is concerning,as despite best efforts,there is no vaccine to combat the bacteria.There are now three species of Orientia and over 20 strains of O.tsutsugamushi.The past attempts to develop a vaccine have been ineffective as they confer homologous strain-specific immunity.Various immunogenic proteins of O.tsutsugamushi have been identified that interact with the extracellular matrix(fibronectin)or vMLL5 receptor and modify the cytoskeleton of non-phagocytic host cells,which aids in host cell adhesion and invasion.These highly conserved proteins involve type specific antigen 56(TSA56),47 kDa,OmpA,and autotransporter proteins(ScaA,ScaB and ScaC).TSA56 is the most immunogenic and contains four types of hypervariable regions.Out of all autotransporter proteins,ScaA provides the homologous strains specific immunity and when coupled with TSA56 it shows better protective immunity against heterologous strains.The review provides detailed insight into the potential immunogenic proteins of Orientia which can be utilized to develop the vaccine.Furthermore,studies focused on highly antigenic proteins will provide more insight into their roles in developing therapeutics and easy-to-handle rapid diagnostic kits.
文摘This article summarizes the nursing management of a pediatric patient with severe scrub typhus complicated by hemophagocytic syndrome(HPS)and septic shock.Key nursing interventions included early recognition and management of septic shock,rational oxygen therapy,fluid resuscitation,administration of vasoactive agents,early and targeted anti-infective therapy,management of hyperpyrexia,care of eschar and edematous skin,strict infection prevention and isolation protocols,and family health education.After 11 days of intensive treatment and nursing care,the patient recovered and was discharged.
文摘Objective:To identify the risk factors for acquiring scrub typhus infection among all age group.Methods:A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Services,Kerala.136 Of serologically confirmed scrub typhus reported during 2018 were included and 270 age and sex-matched healthy controls were selected randomly from different locations in the same area where the cases were reported.The risk factors identified were compared between cases and controls,using univariate and multivariable logistic regression analysis to identify the risk factors for scrub typhus infection.Results:Some key factors like house type with individuals residing in houses with concrete roofs are associated with a higher risk of scrub typhus infection compared to tiled roofs(aOR 0.14,95%CI 0.36-0.56,P=0.005).Housewives exhibit a significantly higher risk(aOR 3.97,95%CI 2.15-8.94,P=0.038)of scrub typhus infection.Environmental factors,including the presence of rats(aOR 3.48,95%CI 1.19-6.53,P=0.023),the presence of domestic animals(aOR 2.98,95%CI 1.67-5.19,P<0.001),wet agricultural fields around the house(aOR 3.64,95%CI 1.50-6.54,P<0.001),and hygiene practices like not changing clothes after work(aOR 2.64,95%CI 1.37-4.68,P=0.024),and disposing of the wastes in their own yard(aOR 4.79,95%CI 3.78-9.55,P=0.043)are identified as significant high-risk factors for scrub typhus infection.Conclusions:These findings will be very useful to create awareness among the public and to undertake a detailed control strategy for scrub typhus.
文摘Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagnosis is often missed because of similarities with oilier tropical febrile infections.Many unusual manifestations are present,and these are described in this review,together with an outline of current knowledge of pathophysiology.Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis,resulting in early administration of appropriate antibiotics.Prognostic indicators for severe disease have not yet been clearly established.
基金supported by the National Basil Research Program of China(973 Program) 2010CBS30200(2010CB530206)the grants from the National Key Science and Technolog Projects of China,No.2009ZX10004-203 and 2008ZX10004-008)
文摘Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombinant 56-kDa proteins of O.tsutsugamushi and mIFA assay were performed on 20 patients from Fujian and 13 patients from Yunnan Province,and 82 sera samples from healthy farmers in Anhui Province and Beijing City in 2009.Comparison of the RDT and mIFA assay was performed by using X test and the P level of 【0.05 was considered to be significance.Results:Among these 82 normal sera samples,the specificity of RDT was 100%for both IgM and IgG tests.In 33 samples from patients with scrub typhus,5 cases were positively detected earlier by RDT than by mIFA in IgM test,and 2 cases were positive in IgG test.Sensitivities of RDT were 93.9%and 90.9%for IgM and IgG,respectively.The sensitivity of combination lest of IgM and IgG was 100%.Geometric mean titer diluted sera from confirmed cases by IFA and RDT assay were 1:37 vs.1:113(P【0.001) in IgM test and 1:99 vs.1:279 (P【0.05) in IgG test.Conclusions:RDT is more sensitivite than mIFA in the early diagnosis of scrub typhus and it is particularly applicable in rural areas.
文摘The zone of alpine scrub and meadow, characterized by highlandsubpolar humid/subhumid climate, is a transitional area from deep gorges to theplateau proper.The natural zone is unique in physical environments and naturalecosystems, and could not be found at the lowlands elsewhere on the earth.Thepredominant type of vegeation is alpine meadow, including Kobresia meadow,herbaceous meadow and swampy meadow. It is an important pasturelands ofanimal husbandry for Tibetan on the plateau. Main vegetion types, animal groups,characteristics of alpine meadow soils, the altitudinal belt and the horizontalzonality of the natural zone, as well as utilization and management of the grasslandsare discussed in the present paper.
基金supported by the Natural Science Foundation of China(No.51804139)the China Postdoctoral Science Foundation(No.2019M652275)the Program of Qingjiang Excellent Young Talents of Jiangxi University of Science and Technology(No.2019003)。
文摘Wet purification technology for nonferrous metal smelting flue gas is important for mercury removal;however, this technology produces a large amounts of spent scrubbing solution that contain mercury. The mercury in these scrubbing solutions pose a great threat to the environment. Therefore, this research provides a novel strategy for removing and recycling mercury from the scrubbing solution, which is significant for decreasing mercury pollution while also allowing for the safe disposal of wastewater and a stable supply of mercury resources. Some critical parameters for the electrochemical reduction of mercury were studied in detail. Additionally, the electrodeposition dynamics and electroreduction mechanism for mercury were evaluated. Results suggested that over 92.4% of mercury could be removed from the scrubbing solution in the form of a Hg-Cu alloy under optimal conditions within 150 min and with a current efficiency of approximately 75%. Additionally, mercury electrodeposition was a quasi-reversible process, and the controlled step was the mass transport of the reactant. A pre-conversion step from Hg(Tu)_(4)^(2+) to Hg(Tu)_(3)^(2+) before mercury electroreduction was necessary. Then, the formed Hg(Tu)_(3)^(2+) on the cathode surface gained electrons step by step. After electrodeposition, the mercury in the spent cathode could be recycled by thermal desorption. The results of the electrochemical reduction of mercury and subsequent recycling provides a practical and easy-to-adopt alternative for recycling mercury resources and decreasing mercury contamination.
文摘Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with periopancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.
基金Department of Health Research,Government of India,New Delhi,India(Grant number:YSS/2020/000116/PRCYSS)。
文摘Scrub typhus is a neglected disease and one of the most serious health problems in the Asia-Pacific region.The disease is caused by an obligate intracellular bacteria Orientia tsutsugamushi,which is transmitted by chigger bites or larval mite bites.Scrub typhus is a threat to billions of people worldwide causing different health complications and acute encephalitis in infants and growing children.The disease causes multiple organ failure and mortality rates may reach up to 70%due to a lack of appropriate healthcare.Currently available genome and proteome databases,and bioinformatics methods are valuable tools to develop novel therapeutics to curb the pathogen.This review discusses the state-of-the-art of information about Orientia tsutsugamushi-mediated scrub typhus and delineates the role of omics technologies to develop drugs against the pathogen.The role of proteome-wide in silico approaches for the identification of therapeutic targets is also highlighted.
基金Supported by The Korea Science and Engineering Foundation Grant Funded by the Korean Government through the Research Center for Resistant Cells, No. R13-2003-009
文摘Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by his- topathological examination of liver biopsy specimens, serological tests and nested polymerase chain reaction. Immunohistochemical staining using a monoclonal an- ti-O. tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes. This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis. Thus, scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses, which causes severe Iobular disarray with diffuse hepatocytic degeneration, necrosis and apoptosis as well as findings indicative of hepatic cholestasis, such as hepatic bile plugs or brown pigmentation of hepatocytes.
文摘Objective:To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods:This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER,Chandigarh,India.One hundred and twenty-six patients aged≥13 years were diagnosed with scrub typhus.Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment(SOFA)score on admission.Results:About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt.Fever(99.21%)and dyspnea(79.36%)were the most frequent complaints.Respiratory failure(81.75%)was the most common organ failure,followed by hepatic(52.38%),coagulative(47.62%),circulatory(33.33%),renal(21.43%),and cerebral dysfunction(13.49%).The median(Q1,Q3)SOFA score was 8(6,9),and 48.41%of the patients had a quick-SOFA score≥2.Organ supports with invasive ventilation(40.48%),vasopressors(36.51%),and renal replacement therapy(7.14%)were frequently required.The in-hospital mortality was 11.90% and was independently predicted by circulatory and hepatic failures on multivariate logistic regression(OR 11.12,95%CI 1.73-71.31 and OR 8.49,95%CI 1.18-61.41,respectively).Conclusions:Most patients had pulmonary dysfunction;circulatory or hepatic failure on admission strongly predicts death.
文摘A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy.Despite intensive therapy,the massive hematochezia worsened and the distal small bowel was resected.Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus.This is the first reported case of pathologically proven small bowel involvement in scrub typhus infection.
基金Supported by National Science and Technology Supporting Plan (2008BADC4B02)
文摘Biogas is a kind of regenerable energy which is inexpensive and friendly to the environment, but the potential ofbiogas is difficult to develop fully in China, for most biogas have badly qualities and the utilization of it is monotonous. The suitable operation term about biogas upgrading by pressurized water scrubbing was researched through the orthogonal test in this study. Two sorts of scrubber packing included the random multidimensional hollow sphere packing and the structured screen packing were also used, and the effects of experiment factors included packing, water temperature, gas flow speed, water flow speed and washing pressure were studied. The results showed that better effect was got when the screen structured packing was used; all the five test factors affected the processing significantly in the arrange as before and had better and better significant effects.
文摘Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.
基金the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant no.HI22C0306).
文摘Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice.
基金Supported by National Natural Science Foundation of China,No.81800721the Postdoctoral Foundation of China,2020M671387.
文摘BACKGROUND Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi(O.tsutsugamushi).Omadacycline,a novel tetracycline,exhibits potent antibacterial efficacy against both typical bacteria and atypical pathogens.However,omadacycline application in the treatment of scrub typhus remains limited.CASE SUMMARY In the present work,we report several cases of scrub typhus,with the main clinical symptoms being fever,the formation of eschars or ulcers,local or systemic lymphadenopathy,headache,myalgia and rash.Blood samples were collected before omadacycline was administered,and O.tsutsugamushi infection was confirmed through targeted next-generation sequencing(tNGS).After two days of treatment,the patients’symptoms,including fever,were alleviated,with no adverse drug reactions.CONCLUSION tNGS is an effective method for diagnosing scrub typhus.Omadacycline can be considered an alternative option for antiinfective therapy in patients with O.tsutsugamushi infections.
文摘Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022.Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody.The data about demography,vital parameters,and lab investigations were collected and analyzed.Results:Ninety-two percent of the patients were from a rural background(92%),86% were farmers and the majority were females.Most patients were 40-60 years old.The major complaints were fever(100%),myalgia(100%),headache(82%),and body swelling(80%).Major complications were pneumonia(68%),multiple organ dysfunction syndrome(62%),hepatitis(44%),and acute kidney injury(42%).Triglyceride levels were>200 mg/dL in 80% of patients,albumin<3.5 g/dL in 98% and eschar mark was present in 24%of patients.Conclusions:Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality.Increasing awareness regarding disease in endemic regions,early screening of patients,and treatment as early as possible could help prevent the patient from severe life-threatening complications.
文摘The present study was undertaken to determine the variability in fiber cell morphology and its length among wood species of the Tamaulipan Thorn Scrub, Northeastern Mexico, used for various uses such as timber for furniture, fence, post, firewood and sources of forage. The results reveal large variability in fiber cell morphology and fiber cell dimensions. The species are classified on the basis of its fiber cell morphology and fiber cell length and recommended for their possible utilization for different purposes. Wood having fibre cells with broad lumen and thin wall could be suitable for the manufacture of paper documented in the literature viz. Acacia farnesciana, Caesalpinia mexicana, Cordia boisiieri, Diospyros palmeri, Forestieria angustifolia, Morus celtifolia, Prosopis laevigata. This technique can be used in preliminary screening of woody species for its utilization for different purposes. Further studies are needed to confirm.
文摘AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes.METHODS Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio(OR) with 95%CI.RESULTS The cohort(n = 81; 35 males) aged 49.4 ± 16.1 years(mean, SD) presented 8.1 ± 3.1 d after symptom onset. The APACHE-Ⅱ score was 15.7 ± 7.0. Fortyeight (59%) patients were ventilated, and 46 (56%) required vasoactive agents. Mortality was 9.9%. ECG changes were non-specific; sinus tachycardia was the most common finding. Myocardial injury was evident in 61.7% of patients and LV systolic dysfunction in 30.9%. A diagnosis of myocarditis was made in 12.3%. In addition, seven patients with regional wall motion abnormalities had LV systolic dysfunction and elevated cardiac enzymes. Mild diastolic dysfunction was observed in 18 (22%) patients. Mild to moderate pericardial effusion was seen in 51%. On multivariate logistic regression analysis, patients with myocarditis tended to be older (OR = 1.04, 95%CI: 0.99-1.09), had shorter symptom duration (OR = 0.69, 95%CI: 0.49-0.98), and tended to stay longer in hospital(OR = 1.17, 95%CI: 0.98-1.40). Myocarditis was not associated with increased mortality.CONCLUSION In scrub typhus infection, cardiac manifestations are frequent and associated with increased morbidity but not mortality.
