{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:07:22Z","timestamp":1784700442006,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"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. Artif. Intell."],"abstract":"<jats:p>This retrospective study enrolled 492 patients with scrub typhus in Jiangmen from 2013 to 2025. Clinical and laboratory data were analyzed using univariate logistic regression and LASSO regression to identify risk factors for severe illness. Seven machine-learning models, including logistic regression, support vector machine, random forest, XGBoost, Naive Bayes, k-nearest neighbor, and decision tree, were constructed and externally validated. Variable importance was ranked using SHAP analysis. Mechanical ventilation represented the strongest predictor of severe disease, indicating that respiratory failure is the core indicator of disease progression. Elevated bilirubin, prolonged coagulation time, and thrombocytopenia were also closely associated with severe scrub typhus. XGBoost achieved the best predictive performance, with AUC values of 0.888 and 0.928 in the training and validation cohorts, respectively. Owing to limited positive cases, mortality prediction yielded lower AUCs (0.856 and 0.814). These findings demonstrate that artificial intelligence models can effectively stratify the severity of scrub typhus and present favorable potential in prognostic assessment.<\/jats:p>","DOI":"10.3389\/frai.2026.1842584","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:56:20Z","timestamp":1784699780000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of artificial intelligence models in the identification of severe scrub typhus"],"prefix":"10.3389","volume":"9","author":[{"given":"Chunyu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ce","family":"Yang","sequence":"additional","affiliation":[{"name":"Endoscopy Center of Jiangmen Central Hospital School of Electronic and Information Engineering, Wuyi University","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuncheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Infection Department of Wuyi Traditional Chinese Medicine Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxia","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Xinhui People\u2019s Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junying","family":"Zeng","sequence":"additional","affiliation":[{"name":"Endoscopy Center of Jiangmen Central Hospital School of Electronic and Information Engineering, Wuyi University","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wencong","family":"Liang","sequence":"additional","affiliation":[{"name":"Endoscopy Center of Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Hong","sequence":"additional","affiliation":[{"name":"Endoscopy Center of Jiangmen Central Hospital School of Electronic and Information Engineering, Wuyi University","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanbo","family":"Qin","sequence":"additional","affiliation":[{"name":"Endoscopy Center of Jiangmen Central Hospital School of Electronic and Information Engineering, Wuyi University","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jiangmen Central Hospital","place":["Jiangmen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0010952","DOI":"10.1371\/journal.pntd.0010952","article-title":"Neurological manifestations of scrub typhus infection: a systematic review and meta-analysis of clinical features and case fatality","volume":"16","author":"Alam","year":"2022","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s13071-015-0784-7","article-title":"Detection of Orientia sp. DNA in rodents from Asia, West Africa and Europe","volume":"8","author":"Cosson","year":"2015","journal-title":"Parasites Vectors"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0317315","DOI":"10.1371\/journal.pone.0317315","article-title":"Association of blood urea nitrogen with 28-day mortality in critically ill patients: a multi-center retrospective study based on the eICU collaborative research database","volume":"20","author":"Deng","year":"2025","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e9619","DOI":"10.1371\/journal.pntd.0009619","article-title":"The burden of scrub typhus in India: a systematic review","volume":"15","author":"Devasagayam","year":"2021","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3390\/tropicalmed10110326","article-title":"Environmental conditions and mite vectors shape the spatiotemporal patterns of scrub typhus in Guangdong Province, mainland China","volume":"10","author":"Fan","year":"2025","journal-title":"Trop Med Infect Dis."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/s41580-021-00407-0","article-title":"A guide to machine learning for biologists","volume":"23","author":"Greener","year":"2022","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e951111","DOI":"10.12659\/MSM.951111","article-title":"Analysis of the epidemiological characteristics and risk factors for severe progression of scrub typhus in the Dali region of China","volume":"32","author":"Huang","year":"2026","journal-title":"Med. Sci. Monit."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1186\/s12943-025-02350-6","article-title":"GP73-dependent regulation of exosome biogenesis promotes colorectal cancer liver metastasis","volume":"24","author":"Huang","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref9","first-page":"19","article-title":"Clinical manifestations and complications of scrub typhus: a hospital based study from north eastern India","volume":"62","author":"Jamil","year":"2014","journal-title":"J. Assoc. Physicians India"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2469651","DOI":"10.1080\/22221751.2025.2469651","article-title":"Expert consensus on the clinical diagnosis and treatment of scrub typhus","volume":"14","author":"Jiang","year":"2025","journal-title":"Emerg Mic Infect."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/1471-2334-10-108","article-title":"Clinical and laboratory findings associated with severe scrub typhus","volume":"10","author":"Kim","year":"2010","journal-title":"BMC Infect. Dis."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3947\/ic.2019.51.2.161","article-title":"Clinical and laboratory predictors associated with complicated scrub typhus","volume":"51","author":"Kim","year":"2019","journal-title":"Infect Chemother."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"873","DOI":"10.4269\/ajtmh.2011.09-0703","article-title":"A comparative study of hepatitis caused by scrub typhus and viral hepatitis a in South Korea","volume":"85","author":"Lee","year":"2011","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.3201\/eid2606.191168","article-title":"Epidemiologic changes of scrub typhus in China, 1952-2016","volume":"26","author":"Li","year":"1952","journal-title":"Emerg. Infect. Dis."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2530696","DOI":"10.1080\/07853890.2025.2530696","article-title":"Development of a machine learning prognostic model for early prediction of scrub typhus progression at hospital admission based on clinical and laboratory features","volume":"57","author":"Lu","year":"2025","journal-title":"Ann. Med."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3390\/tropicalmed3010008","article-title":"A review of scrub typhus (Orientia tsutsugamushi and related organisms): then, now, and tomorrow","volume":"3","author":"Luce-Fedrow","year":"2018","journal-title":"Trop Med Infect Dis."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"883","DOI":"10.3201\/eid2205.150953","article-title":"Q fever, scrub typhus, and rickettsial diseases in children, Kenya, 2011-2012","volume":"22","author":"Maina","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3795","DOI":"10.1080\/21645515.2021.1934355","article-title":"The epidemiology, diagnosis and management of scrub typhus disease in China","volume":"17","author":"Musa","year":"2021","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"209","DOI":"10.4103\/1995-7645.314113","article-title":"Circulatory and hepatic failure at admission predicts mortality of severe scrub typhus patients","volume":"14","author":"Pannu","year":"2021","journal-title":"Asian Pac J Trop Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e13666","DOI":"10.1371\/journal.pntd.0013666","article-title":"Epidemiologic features and potential year of life lost of scrub typhus in China: a nationwide surveillance analysis (2006- 2023)","volume":"19","author":"Peng","year":"2025","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"882","DOI":"10.46234\/ccdcw2025.146","article-title":"Epidemiological characteristics and spatiotemporal cluster analysis of scrub typhus - China, 2006-2023","volume":"7","author":"Qin","year":"2025","journal-title":"China CDC Wkly."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1056\/NEJMra1814259","article-title":"Machine learning in medicine","volume":"380","author":"Rajkomar","year":"2019","journal-title":"New Engl J Med."},{"key":"ref23","first-page":"11","article-title":"A menace without specific feature - scrub typhus a reemerging disease","volume":"69","author":"Roychowdhury","year":"2022","journal-title":"J. Assoc. Physicians India"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0003971","DOI":"10.1371\/journal.pntd.0003971","article-title":"A systematic review of mortality from untreated scrub typhus (Orientia tsutsugamushi)","volume":"9","author":"Taylor","year":"2015","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref25","first-page":"14","article-title":"Vaccines for fungal infections","volume":"28","author":"Tiwari","year":"2015","journal-title":"Natl. Med. J. India"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3389\/fcimb.2012.00170","article-title":"Approaches to vaccines against Orientia tsutsugamushi","volume":"2","author":"Valbuena","year":"2013","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"107151","DOI":"10.1016\/j.ijid.2024.107151","article-title":"Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: a systematic review and meta-analysis","volume":"146","author":"Wang","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.46234\/ccdcw2021.261","article-title":"Epidemiological and clinical features of patients with scrub typhus - Guangzhou City, Guangdong Province, China, 2012-2018","volume":"3","author":"Wei","year":"2021","journal-title":"China CDC Wkly."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0286631","DOI":"10.1371\/journal.pone.0286631","article-title":"Under-diagnosis of vector-borne diseases among individuals suspected of having scrub typhus in South Korea","volume":"18","author":"Won","year":"2023","journal-title":"PLoS One"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e0006062","DOI":"10.1371\/journal.pntd.0006062","article-title":"A review of the global epidemiology of scrub typhus","volume":"11","author":"Xu","year":"2017","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref31","first-page":"301","article-title":"Epidemiological characteristics of scrub typhus in high-incidence areas in the mainland of China, 2006\u20132018","volume":"35","author":"Yue","year":"2020","journal-title":"Disease Surveillance."}],"container-title":["Frontiers in Artificial Intelligence"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frai.2026.1842584\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:56:22Z","timestamp":1784699782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frai.2026.1842584\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":31,"alternative-id":["10.3389\/frai.2026.1842584"],"URL":"https:\/\/doi.org\/10.3389\/frai.2026.1842584","relation":{},"ISSN":["2624-8212"],"issn-type":[{"value":"2624-8212","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1842584"}}