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Scrub Typhus — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsScrub TyphusSCE Infectious Diseases

A 30-year-old man presents with a 1-week history of high fever, severe headache, and myalgia. He returned from a trekking holiday in South Korea 10 days ago. He reports being bitten by chigger mites (larval Trombiculid mites). Examination reveals an eschar on his ankle with regional lymphadenopathy. What is the diagnosis?

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Correct answer: D — Scrub typhus (Orientia tsutsugamushi) — transmitted by chigger mite larvae (Leptotrombidium species)

Eschar (tache noire) at a chigger mite bite site with fever, headache, and lymphadenopathy in a traveller from East/South-East Asia is classic for Scrub Typhus (Orientia tsutsugamushi). Transmitted by larval Trombiculid mites (chiggers) in scrub vegetation. Complications include pneumonitis, encephalitis, and myocarditis. Treatment is Doxycycline 100 mg BD for 7 days (or Azithromycin if Doxycycline is contraindicated). Diagnosis is clinical ± serology (IFA for O. tsutsugamushi IgM). Response to Doxycycline is typically rapid (defervescence within 48 hours).

Reference: UKHSA 2023 – Rickettsial infections; WHO 2020 – Scrub typhus