{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:58:10Z","timestamp":1774371490227,"version":"3.50.1"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>Scrub typhus is a major infectious threat in the Asia-Pacific region. We report an unusual case of scrub typhus in a patient in Singapore who presented with sepsis and acute respiratory distress syndrome but lacked the pathognomonic eschar. The patient recovered after appropriate diagnosis and doxycycline treatment. Rickettsial diseases should be included in the differential diagnosis of febrile illnesses in regions where the diseases are endemic, and absence of eschar should not be the criterion used to rule out scrub typhus.<\/jats:p>","DOI":"10.1128\/jcm.00463-13","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T03:53:26Z","timestamp":1371095606000},"page":"2787-2790","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":10,"title":["Scrub Typhus with Sepsis and Acute Respiratory Distress Syndrome"],"prefix":"10.1128","volume":"51","author":[{"given":"Asok","family":"Kurup","sequence":"first","affiliation":[{"name":"Mount Elizabeth Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneesh","family":"Issac","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Phang","family":"Loh","sequence":"additional","affiliation":[{"name":"DSO National Laboratories, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Too Bou","family":"Lee","sequence":"additional","affiliation":[{"name":"Mount Elizabeth Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Chua","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Bist","sequence":"additional","affiliation":[{"name":"Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Chung","family":"Chao","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lewis","sequence":"additional","affiliation":[{"name":"Henry M. 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