Objective:To summarize the clinical manifestations and diagnosis, treatment experience of vertically transmitted eschar-free scrub typhus in newborns.Methods:A case summary was made.The clinical data of 3 newborns clinically diagnosed as vertically transmitted eschar-free scrub typhus and treated at the Department of Neonatology, the Sixth Affiliated Hospital, Sun Yat-sen University Yuexi Hospital/Xinyi People′s Hospital from August 2022 to July 2024 were retrospectively analyzed.Results:The age of onset of scrub typhus in the 3 newborns was within 24 h after birth.The children presented a fever, the clinical manifestations of early onset sepsis, and also multiple organ damage.Laboratory examination showed that all the 3 children have an abnormal elevation in C-reactive protein, a decrease of blood platelet (PLT) and an increase in D-dimer within 24 h after birth.The diagnosis was confirmed in all the patients via the metagenomic sequencing technology of pathogenic microorganism of blood samples.Two of the 3 children presented hepatomegaly and were treated with Azithromycin.All the children were clinically cured finally.Conclusions:The early clinical manifestation of vertically transmitted eschar-free scrub typhus in newborns is early onset sepsis and easily combined with multi-organ dysfunction, PLT reduction, and D-dimer elevation.Pathogenic microorganism metagenomic sequencing technology is conductive to the diagnosis of the disease, and Azithromycin is effective.

Objective:To summarize the clinical manifestations and diagnosis, treatment experience of vertically transmitted eschar-free scrub typhus in newborns.Methods:A case summary was made.The clinical data of 3 newborns clinically diagnosed as vertically transmitted eschar-free scrub typhus and treated at the Department of Neonatology, the Sixth Affiliated Hospital, Sun Yat-sen University Yuexi Hospital/Xinyi People′s Hospital from August 2022 to July 2024 were retrospectively analyzed.Results:The age of onset of scrub typhus in the 3 newborns was within 24 h after birth.The children presented a fever, the clinical manifestations of early onset sepsis, and also multiple organ damage.Laboratory examination showed that all the 3 children have an abnormal elevation in C-reactive protein, a decrease of blood platelet (PLT) and an increase in D-dimer within 24 h after birth.The diagnosis was confirmed in all the patients via the metagenomic sequencing technology of pathogenic microorganism of blood samples.Two of the 3 children presented hepatomegaly and were treated with Azithromycin.All the children were clinically cured finally.Conclusions:The early clinical manifestation of vertically transmitted eschar-free scrub typhus in newborns is early onset sepsis and easily combined with multi-organ dysfunction, PLT reduction, and D-dimer elevation.Pathogenic microorganism metagenomic sequencing technology is conductive to the diagnosis of the disease, and Azithromycin is effective.