Serodiagnosis of tsutsugamushi fever (scrub typhus) by the indirect immunoperoxidase technique

The indirect immunoperoxidase technique was assessed for the serodiagnosis of tsutsugamushi fever (scrub typhus). The antigens were peritoneal smears prepared from mice infected intraperitoneally with the Karp, Kato, and Gilliam strains of Rickettsia tsutsugamushi. Treatment of the mice with cyclophosphamide apparently increased the number of the rickettsiae, and it minimized the exudate that interfered with the specific staining. The rickettsiae were seen as clusters in the juxtanuclear region of the mesothelial cells and also as free particles outside of the cells. By the indirect immunoperoxidase technique, the sera from all of the patients (49 samples from 30 patients) were positive for the R. tsutsugamushi antibody. The antibody titers (immunoglobulin G [IgG] and IgM) determined by the indirect immunoperoxidase technique correlated with those determined by the indirect immunofluorescence technique. Thus, the indirect immunoperoxidase technique was useful for quantifying both IgG and IgM antibodies to the rickettsia.