Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006
10.3346/jkms.2019.34.e257
- Author:
Jeong Han KIM
1
;
Chang Seop LEE
;
Chisook MOON
;
Yee Gyung KWAK
;
Baek Nam KIM
;
Eu Suk KIM
;
Jae Myung KANG
;
Wan Beom PARK
;
Myoung don OH
;
Sang Won PARK
Author Information
1. Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. hswon1@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Scrub Typhus;
Severe Fever with Thrombocytopenia Syndrome;
Human Granulocytic Anaplasmosis;
Anaplasma phagocytophilum;
Co-Infection
- MeSH:
Anaplasma phagocytophilum;
Anaplasmosis;
Animals;
Arthropods;
Coinfection;
Communicable Diseases;
Diagnosis;
Diagnosis, Differential;
Fever;
Genes, rRNA;
Humans;
Korea;
Polymerase Chain Reaction;
Retrospective Studies;
Reverse Transcriptase Polymerase Chain Reaction;
Scrub Typhus;
Thrombocytopenia
- From:Journal of Korean Medical Science
2019;34(39):e257-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. METHODS: The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. RESULTS: One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. CONCLUSION: We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
