{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T06:34:09Z","timestamp":1769841249605,"version":"3.49.0"},"reference-count":13,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chosun University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Severe fever with thrombocytopenia syndrome (SFTS) and scrub typhus are disorders with similar clinical features; therefore, differentiating between them is difficult. We retrospectively collected data from 183 SFTS and 178 scrub typhus patients and validated an existing scoring system to develop a more sensitive, specific, and objective scoring system. We first applied the scoring systems proposed by Kim et al. to differentiate SFTS from scrub typhus. Multivariable logistic regression revealed that altered mental status, leukopenia, prolonged activated partial thromboplastin time (aPTT), and normal C-reactive protein (CRP) level (\u22641.0 mg\/dL) were significantly associated with SFTS. We changed the normal CRP level from \u22641.0 mg\/dL to \u22643.0 mg\/dL and replaced altered mental status with the creatine kinase (CK) level. The modified scoring system showed 97% sensitivity and 96% specificity for SFTS (area under the curve (AUC): 0.983) and a higher accuracy than the original scoring system (p = 0.0308). This study\u2019s scoring system had 97% sensitivity and 98% specificity for SFTS (AUC: 0.992) and a higher accuracy than Kim et al.\u2019s original scoring system (p = 0.0308). Our scoring system that incorporated leukopenia, prolonged aPTT, normal CRP level (\u22643.0 mg\/dL), and elevated CK level (&gt;1000 IU\/L) easily differentiated SFTS from scrub typhus in an endemic area.<\/jats:p>","DOI":"10.3390\/v14051093","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:18:11Z","timestamp":1653005891000},"page":"1093","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Development of a Scoring System to Differentiate Severe Fever with Thrombocytopenia Syndrome from Scrub Typhus"],"prefix":"10.3390","volume":"14","author":[{"given":"Hyoung","family":"Sul","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, College of Medicine, Chosun University, Gwangju 61452, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na Ra","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, College of Medicine, Chosun University, Gwangju 61452, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6373-0922","authenticated-orcid":false,"given":"Dong-Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, College of Medicine, Chosun University, Gwangju 61452, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-3889","authenticated-orcid":false,"given":"Jieun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yeungnam University Medical Center, Daegu 38541, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1577-678X","authenticated-orcid":false,"given":"Sook In","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Yeol","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu 42601, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2788-1392","authenticated-orcid":false,"given":"Ji Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu 42601, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5140-3964","authenticated-orcid":false,"given":"Kyungmin","family":"Huh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-8045","authenticated-orcid":false,"given":"Yee Gyung","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Won","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Chungbuk University Hospital, Cheongju 28644, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Yeon","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, School of Medicine, Ajou University Hospital, Suwon 16499, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Sik","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Dong-A University Hospital, Busan 49315, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Pusan National University Hospital, Busan 50612, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Hee","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-7170","authenticated-orcid":false,"given":"Joon-Sup","family":"Yeom","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3819-9057","authenticated-orcid":false,"given":"Hyungdon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon 24252, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/S1473-3099(14)70718-2","article-title":"Severe fever with 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