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Pneumonia due to scrub typhus infection: a case report
Zhiguang Wang1, Yuhua Piao1, Zhongjian An1
1Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yanbian University, Yanji, China.
BMC Pulmonary Medicine
|July 12, 2025
Summary
Scrub typhus can cause pneumonia. Metagenomic next-generation sequencing (mNGS) successfully diagnosed Orientia tsutsugamushi in a patient with severe pneumonia, leading to effective doxycycline treatment.
Area of Science:
- Infectious Diseases
- Pulmonary Medicine
- Microbiology
Background:
- Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, transmitted via infected mite bites.
- Typical symptoms include fever, headache, myalgia, and eschar; severe cases may present with respiratory issues like pneumonia or ARDS.
- This case focuses on scrub typhus-induced pneumonia, a potentially severe manifestation.
Purpose of the Study:
- To present a case of scrub typhus pneumonia.
- To highlight the diagnostic utility of metagenomic next-generation sequencing (mNGS) in identifying the causative agent.
- To demonstrate the effectiveness of doxycycline treatment.
Main Methods:
- A 58-year-old woman presented with pneumonia symptoms.
- Bronchoscopy and bronchoalveolar lavage fluid (BALF) collection were performed.
- Metagenomic next-generation sequencing (mNGS) was used to analyze BALF for pathogen identification.
Main Results:
- mNGS of BALF confirmed Orientia tsutsugamushi as the causative pathogen.
- The patient received oral doxycycline (100 mg twice daily) for one month.
- The patient's pneumonia showed improvement following treatment.
Conclusions:
- Scrub typhus pneumonia presents diagnostic challenges.
- mNGS is a valuable tool for identifying rare pathogens like Orientia tsutsugamushi in pneumonia.
- Prompt diagnosis and appropriate antibiotic treatment (doxycycline) are crucial for managing scrub typhus pneumonia.
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