{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:45:57Z","timestamp":1791783957127,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":283,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Tropical Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Scrub typhus is an acute zoonotic disease caused by\n                      <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                      . There are limited reports on scrub typhus in pregnancy, and the misdiagnosis rate is relatively high, potentially leading to adverse maternal and fetal outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study analyzed 19 pregnant patients with scrub typhus admitted to the People\u2019s Hospital of Ximeng Wa Autonomous County, Southwest China, from August 2023 to November 2025. Epidemiological, clinical, test, treatment, and outcome data were collected and descriptively analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients were farmers, with 73.68% reporting a history of outdoor activities. Common symptoms included fever (100%), myalgia (78.94%), headache (57.89%), and eschar (94.74%). Laboratory findings revealed elevated transaminases (ALT or AST 94.74%) and decreased eosinophil percentages (89.47%). Initial misdiagnosis occurred in 10.53% (upper respiratory infection). Among the 18 patients treated with azithromycin, fever resolution occurred within 1 to 5\u2009days. No maternal deaths occurred. However, adverse fetal outcomes included spontaneous miscarriage (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), embryonic arrest (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and embryo demise (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093). Among 19 cases, 14 resulted in live births; 2 premature infants required pediatric care, and all live\u2010born newborns showed normal development at six\u2010month follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Scrub typhus in pregnancy poses serious maternal\u2010fetal risks. Early clinical recognition and prompt azithromycin therapy are crucial for improving maternal and perinatal outcomes, especially in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jotm\/4922171","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:14:38Z","timestamp":1791782078000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Scrub Typhus in Pregnancy: A Retrospective Observational Study From Primary Hospital of Southwest China"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6510-1031","authenticated-orcid":false,"given":"Mengji","family":"Zhang","sequence":"first","affiliation":[{"name":"The First People\u2019s Hospital of Yunnan Province  Kunming Yunnan China  ypfph.com"},{"name":"The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China  kmust.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Pan","sequence":"additional","affiliation":[{"name":"The First People\u2019s Hospital of Yunnan Province  Kunming Yunnan China  ypfph.com"},{"name":"The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China  kmust.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Lan","sequence":"additional","affiliation":[{"name":"The People\u2019s Hospital of Ximeng Va Autonomous County  Pu\u2019er Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueming","family":"Li","sequence":"additional","affiliation":[{"name":"The People\u2019s Hospital of Ximeng Va Autonomous County  Pu\u2019er Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9409-3417","authenticated-orcid":false,"given":"Xiaomei","family":"Wu","sequence":"additional","affiliation":[{"name":"The First People\u2019s Hospital of Yunnan Province  Kunming Yunnan China  ypfph.com"},{"name":"The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China  kmust.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.4103\/jvbd.jvbd_129_25"},{"key":"e_1_2_12_2_2","volume-title":"Technical Guidelines for the Prevention and Control of Scrub Typhus (Trial Version)[R]","author":"Chinese Center for Disease Control and Prevention","year":"2009"},{"key":"e_1_2_12_3_2","first-page":"683","article-title":"Epidemiological Characteristics of Scrub Typhus in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan Province From 2010 to 2024","volume":"43","author":"Gou C.","year":"2025","journal-title":"Chinese Journal of Parasitology & Parasitic Diseases"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2408645"},{"key":"e_1_2_12_5_2","first-page":"241","article-title":"Clinical Characteristics of Scrub Typhus in 159 Patients From 2019 to 2023","volume":"25","author":"Ma H.","year":"2025","journal-title":"Chinese Journal of Infection and Chemotherapy"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012829"},{"key":"e_1_2_12_7_2","first-page":"11","article-title":"A Menace Without Specific Feature-Scrub Typhus a Reemerging Disease","volume":"69","author":"Roychowdhury S.","year":"2022","journal-title":"Journal of the Association of Physicians of India"},{"key":"e_1_2_12_8_2","first-page":"460","article-title":"Clinical Features of 132 Cases of Tsutsugamushi Disease in Suqian Area","volume":"21","author":"Zhu F.","year":"2021","journal-title":"Journal of Tropical Medicine"},{"key":"e_1_2_12_9_2","article-title":"Prevalence Rate and Distribution of Eschar in Patients With Scrub Typhus","author":"Yoo J. 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