A Clinical Case of Scrub Typhus in the United States Forces Korea Patient with Eschar and Genetic Identification of Orientia tsutsugamushi Using Multiplex PCR-Based Next-Generation Sequencing

An epidemiological investigation was conducted for a scrub typhus case reported in a U.S. Forces Korea military patient in the Republic of Korea in November 2018. The patient had a fever, maculopapular rash, and an eschar. The full-length sequence of Orientia tsutsugamushi 56-kDa type-specific antigen (TSA) gene was obtained from eschar tissue by multiplex PCR-based Next Generation Sequencing for genetic identification. Based on the 56-kDa TSA gene, the O. tsutsugamushi aligned most closely with the Boryong strain.

[1]  Kkothanahreum Park,et al.  Active Targeted Surveillance to Identify Sites of Emergence of Hantavirus. , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  G. Palacios,et al.  Comparison of targeted next-generation sequencing for whole-genome sequencing of Hantaan orthohantavirus in Apodemus agrarius lung tissues , 2019, Scientific Reports.

[3]  S. H. Kim,et al.  Molecular Epidemiology of an Orientia tsutsugamushi Gene Encoding a 56-kDa Type-Specific Antigen in Chiggers, Small Mammals, and Patients from the Southwest Region of Korea. , 2018, The American journal of tropical medicine and hygiene.

[4]  S. Dittrich,et al.  Endemic Scrub Typhus in South America. , 2016, The New England journal of medicine.

[5]  A. Richards,et al.  Q Fever, Scrub Typhus, and Rickettsial Diseases in Children, Kenya, 2011–2012 , 2016, Emerging infectious diseases.

[6]  S. Youn,et al.  Current situation of scrub typhus in South Korea from 2001–2013 , 2015, Parasites & Vectors.

[7]  A. Richards,et al.  Serosurveillance of scrub typhus in small mammals collected from military training sites near the DMZ, Northern Gyeonggi-do, Korea, and analysis of the relative abundance of chiggers from mammals examined. , 2010, The Korean journal of parasitology.

[8]  M. Turell,et al.  Serological surveillance of scrub typhus, murine typhus, and leptospirosis in small mammals captured at firing points 10 and 60, Gyeonggi province, Republic of Korea, 2001-2005. , 2010, Vector borne and zoonotic diseases.

[9]  P. Fuerst,et al.  Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  H. Urakami,et al.  Phylogenetic analysis of Orientia tsutsugamushi strains based on the sequence homologies of 56-kDa type-specific antigen genes. , 1999, FEMS microbiology letters.

[11]  D. H. Walker,et al.  A case of scrub typhus probably acquired in Africa. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  J. Arthur,et al.  Scrub typhus in Korea: importance of early clinical diagnosis in this newly recognized endemic area. , 1993, Military medicine.

[13]  B. Roe,et al.  The 56-kilodalton major protein antigen of Rickettsia tsutsugamushi: molecular cloning and sequence analysis of the sta56 gene and precise identification of a strain-specific epitope , 1990, Infection and immunity.