{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:37:53Z","timestamp":1790699873656,"version":"4.1.0"},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:p>Scrub typhus is transmitted by trombiculid mites and is endemic to East and Southeast Asia and Northern Australia. The clinical syndrome classically consists of a fever, rash, and eschar, but scrub typhus also commonly presents as an undifferentiated fever that requires laboratory confirmation of the diagnosis, usually by indirect fluorescent antibody (IFA) assay. We discuss the limitations of IFA, debate the value of other methods based on antigen detection and nucleic acid amplification, and outline recommendations for future study.<\/jats:p>","DOI":"10.4269\/ajtmh.2010.09-0233","type":"journal-article","created":{"date-parts":[[2010,3,5]],"date-time":"2010-03-05T13:59:46Z","timestamp":1267797586000},"page":"368-370","source":"Crossref","is-referenced-by-count":181,"title":["Diagnosis of Scrub Typhus"],"prefix":"10.4269","volume":"82","author":[{"given":"Gavin C. K. W.","family":"Koh","sequence":"first","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Wellcome Trust\u2013Mahosot Hospital\u2013Oxford Tropical Medicine Research Collaboration..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Maude","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Wellcome Trust\u2013Mahosot Hospital\u2013Oxford Tropical Medicine Research Collaboration..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Paris","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Wellcome Trust\u2013Mahosot Hospital\u2013Oxford Tropical Medicine Research Collaboration..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Newton","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Wellcome Trust\u2013Mahosot Hospital\u2013Oxford Tropical Medicine Research Collaboration..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart D.","family":"Blacksell","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Wellcome Trust\u2013Mahosot Hospital\u2013Oxford Tropical Medicine Research Collaboration..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Scrub typhus","first-page":"463","author":"Groves","year":"1994"},{"key":"R2","series-title":"Trans R Soc Trop Med Hyg","first-page":"354","article-title":"Paediatric scrub typhus in Thailand: a study of 73 confirmed cases","volume":"98","author":"Silpapojakul","year":"2004"},{"key":"R3","series-title":"Am J Trop Med Hyg","first-page":"400","article-title":"Comparative evaluation of the indirect immunoperoxidase test for the serodiagnosis of rickettsial disease","volume":"38","author":"Kelly","year":"1988"},{"key":"R4","series-title":"Clin Infect Dis","first-page":"391","article-title":"Scrub typhus serologic testing with the indirect 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1996\u20132000","volume":"22","author":"Anonymous","year":"2001"},{"key":"R9","series-title":"Southeast Asian J Trop Med Public Health","first-page":"91","article-title":"Patient and sample-related factors that effect the success of in vitro isolation of Orientia tsutsugamushi","volume":"38","author":"Luksameetanasan","year":"2007"},{"key":"R10","series-title":"Transfusion","first-page":"680","article-title":"Recovery and viability of Orientia tsutsugamushi from packed red cells and the danger of acquiring scrub typhus from blood transfusion","volume":"38","author":"Casleton","year":"1998"},{"key":"R11","series-title":"Clin Infect Dis","first-page":"1296","article-title":"Clinical usefulness of eschar polymerase chain reaction for the diagnosis of scrub typhus: a prospective study","volume":"43","author":"Kim","year":"2006"},{"key":"R12","series-title":"Trans R Soc Trop Med Hyg","first-page":"360","article-title":"Evaluation of nested PCR for the diagnosis of scrub typhus among patients with acute pyrexia of unknown origin","volume":"98","author":"Saisongkorn","year":"2004"},{"key":"R13","series-title":"Trans R Soc Trop Med Hyg","first-page":"1239","article-title":"Simple, rapid and sensitive detection of Orientia tsutsugamushi by loop-isothermal DNA amplification","volume":"102","author":"Paris","year":"2008"},{"key":"R14","series-title":"J Clin Microbiol","first-page":"1637","article-title":"Scrub typhus","volume":"31","author":"Furuya","year":"1993"},{"key":"R15","series-title":"Am J Trop Med Hyg","first-page":"1099","article-title":"Rapid diagnosis of scrub typhus in rural Thailand using polymerase chain reaction","volume":"75","author":"Sonthayanon","year":"2006"},{"key":"R16","series-title":"J Clin Microbiol","first-page":"430","article-title":"Association of high Orientia tsutsugamushi DNA loads with disease of greater severity in adults with scrub typhus","volume":"47","author":"Sonthayanon","year":"2009"},{"key":"R17","series-title":"Am J Trop Med 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