How is scrub typhus treated?

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

The current treatment for scrub typhus is administration of a tetracycline (most commonly doxycycline). [59] Chloramphenicol is also effective, and macrolides have been used as well. Relapses may occur if the antibiotics are not taken for a long enough period. Intravenous (IV) antibiotics may be administered to patients who are seriously ill and unable to swallow pills.

When patients who are HIV-positive become infected with certain strains of scrub typhus, their viral load can dramatically decrease. This is an important area of research. A proposed hypothesis is that patients infected with HIV who acquire scrub typhus have a powerful immune response raised to the scrub typhus and that is being turned against the HIV. [60]

Diet and activity are as tolerated. Inpatient care may be necessary for patients with severe scrub typhus. In such cases, meticulous supportive management is necessary to abort progression to disseminated intravascular coagulation (DIC) or circulatory collapse.


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