{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:42:48Z","timestamp":1776436968623,"version":"3.51.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>\n                    Scrub typhus, a zoonosis caused by\n                    <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                    (\n                    <jats:italic>O. tsutsugamushi<\/jats:italic>\n                    ), remains a significant public health threat in the Asia-Pacific region. This disease is transmitted through the bite of infected trombiculid mite larvae (chiggers) and typically manifests as acute undifferentiated fever during the early stage. Despite the availability of targeted antibiotic therapies, delayed diagnosis frequently leads to severe complications and fatal outcomes. Here, we report a severe imported paediatric case in Beijing, a city in China's temperate zone, involving a 12-year-old girl with a recent travel history to Yunnan Province. The patient presented with fever, characteristic eschar, regional lymphadenopathy, and septic shock, ultimately progressing to multiorgan dysfunction syndrome. Whole-genome metagenomic next-generation sequencing (mNGS) of blood, cerebrospinal fluid (CSF), and sputum samples revealed\n                    <jats:italic>O. tsutsugamushi<\/jats:italic>\n                    with high sequence read counts, whereas blood cultures remained negative for other bacterial pathogens. Subsequent PCR amplification and Sanger sequencing confirmed the mNGS findings. Phylogenetic analysis of the TSA56 gene classified the strain within the Karp cluster. Serological analysis revealed the presence of\n                    <jats:italic>O. tsutsugamushi<\/jats:italic>\n                    -specific IgM and IgG antibodies. This severe paediatric case highlights the importance of considering travel-associated scrub typhus in the differential diagnosis of febrile illnesses in non-endemic regions. This is particularly relevant for patients with a history of insect bites in areas known to be endemic for\n                    <jats:italic>O. tsutsugamushi<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.3389\/fped.2026.1733143","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:45:38Z","timestamp":1776433538000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: An imported severe case of paediatric scrub typhus with Karp B subgenotype in non-endemic Northern China, Beijing"],"prefix":"10.3389","volume":"14","author":[{"given":"Yiyang","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Paediatric Critical Care Medicine, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuchi","family":"Lv","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Capital Medical University","place":["Beijing, China"]},{"name":"Beijing Research Center for Respiratory Infectious Diseases, Beijing Pediatric Research Institute, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]},{"name":"Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siqi","family":"Chen","sequence":"additional","affiliation":[{"name":"Hainan Medical University-the University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Basic Medicine and Life Sciences, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Paediatric Critical Care Medicine, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kechun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatric Critical Care Medicine, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengde","family":"Xie","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Capital Medical University","place":["Beijing, China"]},{"name":"Beijing Research Center for Respiratory Infectious Diseases, Beijing Pediatric Research Institute, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]},{"name":"Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feifei","family":"Yin","sequence":"additional","affiliation":[{"name":"Hainan Medical University-the University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Basic Medicine and Life Sciences, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Xu","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Capital Medical University","place":["Beijing, China"]},{"name":"Beijing Research Center for Respiratory Infectious Diseases, Beijing Pediatric Research Institute, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]},{"name":"Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Paediatric Critical Care Medicine, Beijing Children\u2019s Hospital, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengsong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory, Beijing Children\u2019s Hospital, Beijing Research Center for Respiratory Infectious Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Children\u2019s Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.3201\/eid2606.191168","article-title":"Epidemiologic changes of scrub typhus in China, 1952\u20132016","volume":"26","author":"Li","year":"2020","journal-title":"Emerg Infect 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