References
- Centers for Disease Control and Prevention. Clinical overview of scrub typhus. Atlanta, GA: CDC; May 15, 2024. Available at:
https://www.cdc.gov/typhus/hcp/clinical-overview/clinical-overview-of-scrub-typhus.html . Accessed October 2, 2025. - Devamani C, Alexander N, Chandramohan D, Stenos J, Cameron M, Abhilash KPP, Mangtani P, Blacksell S, Vu HTT, Rose W, Schmidt WP. Incidence of Scrub Typhus in Rural South India. N Engl J Med. 2025;392(11):1089–1099. DOI: 10.1056/NEJMoa2408645
- Dasgupta S, Asish PR, Rachel G, Bagepally BS, Chethrapilly Purushothaman GK. Global seroprevalence of scrub typhus: a systematic review and meta-analysis. Sci Rep. 2024;14(1):
10895 . DOI: 10.1038/s41598-024-61555-9 - Reba H, Gunasekaran K, T AM. Neurological complications of scrub typhus. Curr Opin Infect Dis. 2025;38(5):355–363. DOI: 10.1097/QCO.0000000000001135
- Basu S, Chakravarty A. Neurological Manifestations of Scrub Typhus. Curr Neurol Neurosci Rep. 2022;22(8):491–498. DOI: 10.1007/s11910-022-01215-5
- Alam AM, Gillespie CS, Goodall J, Damodar T, Turtle L, Vasanthapuram R, Solomon T, Michael BD. Neurological manifestations of scrub typhus infection: A systematic review and meta-analysis of clinical features and case fatality. PLoS Negl Trop Dis. 2022;16(11):
e0010952 . DOI: 10.1371/journal.pntd.0010952 - Mondal R, Deb S, Dhauria M, Sen P, Sarkar V, Sarkar S, Chowdhury D, Lahiri D, Roy J, Benito-León J. Scrub typhus-associated movement and gait disorders: A systematic review with principal component analysis and in silico mechanistic modelling. Trop Med Int Health. 2025;30(6):459–480. DOI: 10.1111/tmi.14114
- Majumdar S, Benjamin RN, Ralph R, Mahasampath G, Abhilash KPP, Samson N, Sudarsan TI, Prakash JA, Varghese GM. Neurological Manifestations of Scrub Typhus: The Clinical Spectrum, Determinants, and Outcome. Neurol India. 2025;73(1):88–94. DOI: 10.4103/ni.ni_139_22
- Garg D, Manesh A. Neurological Facets of Scrub Typhus: A Comprehensive Narrative Review. Ann Indian Acad Neurol. 2021;24(6):849–864. DOI: 10.4103/aian.aian_739_21
- Garg RK, Pandey S, Jain A, Suresh V, Singhal S. Movement Disorders Associated with Scrub Typhus: A Systematic Review. PROSPERO. 2025;CRD420251156525. Available at:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251156525 . Accessed September 30, 2025. - Chandra A, Chatterjee R. Eschar: A Very Important Clue in Diagnosis of Scrub Typhus. QJM. 2025;
hcaf201 . DOI: 10.1093/qjmed/hcaf201. Epub ahead of print. - Koh GC, Maude RJ, Paris DH, Newton PN, Blacksell SD. Diagnosis of scrub typhus. Am J Trop Med Hyg. 2010;82(3):368–70. DOI: 10.4269/ajtmh.2010.09-0233
- Janardhanan J, Trowbridge P, Varghese GM. Diagnosis of scrub typhus. Expert Rev Anti Infect Ther. 2014;12(12):1533–40. DOI: 10.1586/14787210.2014.974559
- The Movement Disorder Society. About movement disorders: clinical information, resources, tools, and education about common movement disorders. Available at:
https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews.htm . Accessed September 30, 2025. - Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23(2):60–3. DOI: 10.1136/bmjebm-2017-110853
- Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020;223(1):36–41. DOI: 10.1016/j.ajog.2020.04.013
- Chiou YH, Yang CJ, Lai TH. Scrub typhus associated with transient parkinsonism and myoclonus. J Clin Neurosci. 2013;20(1):182–3. DOI: 10.1016/j.jocn.2012.01.047
- Koti N, Mareddy AS, Nagri SK, Kudru CU. Dancing eyes and dancing feet in scrub typhus. Australas Med J. 2015;8(12):371–2. DOI: 10.4066/AMJ.2015.2514
- Ralph R, Prabhakar AT, Sathyendra S, Carey R, Jude J, Varghese GM. Scrub Typhus-Associated Opsoclonus: Clinical Course and Longitudinal Outcomes in an Indian Cohort. Ann Indian Acad Neurol. 2019;22(2):153–158. DOI: 10.4103/aian.AIAN_198_18
- Pai H, Sohn S, Seong Y, Kee S, Chang WH, Choe KW. Central nervous system involvement in patients with scrub typhus. Clin Infect Dis. 1997;24(3):436–40. DOI: 10.1093/clinids/24.3.436
- Liang Y, Aditi, Onyoni F, Wang H, Gonzales C, Sunyakumthorn P, Wu P, Samir P, Soong L. Brain transcriptomics reveal the activation of neuroinflammation pathways during acute Orientia tsutsugamushi infection in mice. Front Immunol. 2023;14:
1194881 . DOI: 10.3389/fimmu.2023.1194881 - Otterdal K, Janardhanan J, Astrup E, Ueland T, Prakash JA, Lekva T, Abraham OC, Thomas K, Damås JK, Mathews P, Mathai D, Aukrust P, Varghese GM. Increased endothelial and macrophage markers are associated with disease severity and mortality in scrub typhus. J Infect. 2014;69(5):462–9. DOI: 10.1016/j.jinf.2014.06.018
- Yum KS, Na SJ, Lee KO, Ko JH. Scrub typhus meningo-encephalitis with focal neurologic signs and associated brain MRI abnormal findings: literature review. Clin Neurol Neurosurg. 2011;113(3):250–3. DOI: 10.1016/j.clineuro.2010.11.007
- Soong L. Dysregulated Th1 Immune and Vascular Responses in Scrub Typhus Pathogenesis. J Immunol. 2018;200(4):1233–1240. DOI: 10.4049/jimmunol.1701219
- Cho NH, Kim HR, Lee JH, Kim SY, Kim J, Cha S, Kim SY, Darby AC, Fuxelius HH, Yin J, Kim JH, Kim J, Lee SJ, Koh YS, Jang WJ, Park KH, Andersson SG, Choi MS, Kim IS. The Orientia tsutsugamushi genome reveals massive proliferation of conjugative type IV secretion system and host-cell interaction genes. Proc Natl Acad Sci U S A. 2007;104(19):7981–6. DOI: 10.1073/pnas.0611553104
- Fisher J, Card G, Soong L. Neuroinflammation associated with scrub typhus and spotted fever group rickettsioses. PLoS Negl Trop Dis. 2020;14(10):
e0008675 . DOI: 10.1371/journal.pntd.0008675 - Jung J, Jung Y, Gill B, Kim C, Hwang KJ, Ju YR, Lee HJ, Chu H, Hwang GS. Metabolic responses to Orientia tsutsugamushi infection in a mouse model. PLoS Negl Trop Dis. 2015;9(1):
e3427 . DOI: 10.1371/journal.pntd.0003427 - Ogawa M, Satoh M, Kataoka M, Ando S, Saijo M. Nitric oxide enhanced the growth of an obligated intracellular bacterium Orientia tsutsugamushi in murine macrophages. Microb Pathog. 2017;107:335–340. DOI: 10.1016/j.micpath.2017.04.012
- You H, Song J, Kim S, Oh SM, Hwang JH, Hwang JH, Yoo WH, Choi Y, Lee CS. Scrub typhus association with autoimmune biomarkers and clinical implications. PLoS Negl Trop Dis. 2025;19(1):
e0012766 . DOI: 10.1371/journal.pntd.0012766
