From the Research
Scrub typhus is an infectious disease caused by the bacterium Orientia tsutsugamushi, transmitted to humans through the bite of infected larval mites (chiggers), and the first-line treatment is doxycycline, typically administered at 100 mg twice daily for 7-14 days 1.
Key Characteristics of Scrub Typhus
- The disease presents with fever, headache, muscle pain, and a characteristic eschar (black scab) at the bite site, followed by a maculopapular rash.
- It can lead to severe complications including respiratory distress, meningoencephalitis, and multi-organ failure if left untreated or if treatment is delayed.
- Prevention involves wearing protective clothing, using insect repellents containing DEET, and avoiding areas with high grass or brush where mites commonly reside.
Treatment Options
- For pregnant women or those allergic to tetracyclines, alternatives include azithromycin (500 mg on day 1, followed by 250 mg daily for 4 days) or chloramphenicol (500 mg four times daily for 7-14 days) 2.
- Azithromycin has been shown to be as effective as doxycycline in treating scrub typhus, with a favorable outcome in patients treated with azithromycin (risk ratio 0.83,95% confidence interval 0.23-2.98) 2.
- Other treatment options include minocycline, which has been shown to be effective in treating noncomplicated scrub typhus, with a response rate of 96% 3.
Importance of Early Treatment
- Treatment should begin promptly upon clinical suspicion, even before laboratory confirmation, as delayed treatment can lead to severe complications.
- The bacterium enters human cells and multiplies, causing vasculitis and subsequent organ dysfunction, which explains the systemic nature of the infection and the importance of early antibiotic intervention to halt bacterial replication 1.
- Nearly all patients (93.6%) become afebrile within 72 hours after use of tetracycline antibiotics, highlighting the effectiveness of prompt treatment 3.