Omadacycline in the treatment of scrub typhus: Three case reports

Abstract

BACKGROUND

Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi (O. tsutsugamushi). Omadacycline, a novel tetracycline, exhibits potent antibacterial efficacy against both typical bacteria and atypical pathogens. However, omadacycline application in the treatment of scrub typhus remains limited.

CASE SUMMARY

In the present work, we report several cases of scrub typhus, with the main clinical symptoms being fever, the formation of eschars or ulcers, local or systemic lymphadenopathy, headache, myalgia and rash. Blood samples were collected before omadacycline was administered, and O. tsutsugamushi infection was confirmed through targeted next-generation sequencing (tNGS). After two days of treatment, the patients’ symptoms, including fever, were alleviated, with no adverse drug reactions.

CONCLUSION

tNGS is an effective method for diagnosing scrub typhus. Omadacycline can be considered an alternative option for antiinfective therapy in patients with O. tsutsugamushi infections.

Keywords: Omadacycline; Scrub typhus; Orientia tsutsugamushi; Targeted next-generation sequencing; Eschar; Case report

Core Tip: Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi (O. tsutsugamushi). In the present work, we report three cases of scrub typhus, with the main clinical symptoms being fever, the formation of eschar or ulcers, local or systemic lymphadenopathy, headache, myalgia and rash. Blood samples were collected before the administration of omadacycline. Omadacycline can be considered an alternative option for anti infective therapy in patients with O. tsutsugamushi infections.