Takaaki Yoshimoto and Taiji Yoshimoto
Department of Internal Medicine, Hitachi-Ota City Kegano Clinic, Japan
Chief, Department of Gastroenterology, Musashino Tokushukai Hospital, Tokyo,Japan
Scrub typhus (Tsutsugamushi disease) is a zoonotic bacterial infection with three main clinical
manifestations, fever, skin eruption, and eschar; a necrotic lesion of the skin presented at the site of
an infected chigger bite, pathognomonic of scrub typhus. The World Health Organization (WHO)
in 1999 stated that: scrub typhus is probably one of the most underdiagnosed and an underreported
disease that often requires hospitalization. Scrub typhus is a serious health problem especially in
the region known as Tsutsugamushi Triangle. Without appropriate treatment, the case fatality of
scrub typhus can reach higher than 30% as a result of multi-organ failure. Scrub typhus is the most
common rickettsial infection in Japan and was classified as fourth notifiable infectious disease in
1999. In this article, we review the history of scrub typhus in Japan, and provide new information,
chief events and current status of epidemiology. For a better understanding of scrub typhus, a
typical case of Tsutsugamushi disease was presented.
Rickettsia; Scrub typhus; Eschar; Skin eruption; Tsutsugamushi triangle
Yoshimoto Takaaki, Yoshimoto Taiji. Scrub Typhus in Japan. Am J Clin Microbiol Antimicrob. 2019; 2(3): 1042.