How is scrub typhus diagnosed?

Updated: Apr 19, 2018
  • Author: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS; Chief Editor: Russell W Steele, MD  more...
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Answer

Laboratory studies in patients with scrub typhus may reveal the following:

  • Early lymphopenia with late lymphocytosis

  • Decreased CD4:CD8 lymphocyte ratio

  • Thrombocytopenia

  • Hematologic manifestations may be confused with dengue infection

  • Elevated transaminase levels (75-95% of patients)

  • Hypoalbuminemia (50% of cases)

Laboratory studies of choice are serologic tests for antibodies, including the following:

  • Indirect immunoperoxidase test

  • Indirect fluorescent antibody test

  • Dot immunoassay

  • Rapid immunochromatographic tests for detection of IgM and IgG

  • Polymerase chain reaction (PCR) assay

  • Rapid diagnostic reagent for scrub typhus

  • Weil-Felix OX-K strain agglutination reaction

Chest radiography may reveal pneumonitis, especially in the lower lung fields.

See Workup for more detail.


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