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KMID : 0191120190340390257
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Journal of Korean Medical Science
2019 Volume.34 No. 39 p.257 ~ p.257
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Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006
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Kim Jeong-Han
Lee Chang-Seop
Moon Chi-Sook
Kwak Yee-Gyung
Kim Baek-Nam
Kim Eu-Suk
Kang Jae-Myung
Park Wan-Beom
Oh Myoung-Don
Park Sang-Won
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Abstract
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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.
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KEYWORD
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Scrub Typhus, Severe Fever with Thrombocytopenia Syndrome, Human Granulocytic Anaplasmosis, Anaplasma phagocytophilum, Co-Infection
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