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What are the tests used to diagnose scrub typhus infection?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

My younger brother recently went on a hiking trip, and now he has a fever, chills, and a weird scab-like thing on his leg. The rash is spreading a bit, and he feels exhausted all the time. We thought it was a normal infection, but it has been five days, and he is not getting better. Could this be scrub typhus? What kind of tests should we do to confirm? Also, is this contagious? Should we be worried about the rest of the family? If it is scrub typhus, what’s the best treatment, and how long does it take to recover?

Please help me.

Thanks.

Answered by Dr. Reema Wankar

Hi,

Welcome to icliniq.com.

I can understand your concern.

Sorry to hear about your brother. As you have mentioned, the symptoms of hiking trips could be scrub typhus or mosquito-borne diseases like dengue or malaria.

Symptoms of scrub typhus usually begin within ten days after infection. Signs and symptoms include:

  1. Fever and chills

  2. Headache.

  3. Body aches and muscle pain.

  4. A dark, scab-like region at the site of the chigger bite (also known as eschar).

  5. Mental changes, ranging from confusion to coma.

  6. Enlarged lymph nodes.

  7. Rash.

If not treated appropriately, scrub typhus can be fatal and may lead to organ damage and severe bleeding.

Scrub typhus is not a contagious disease. It is a mite-borne disease and is transmitted to humans through the bite of infected chigger larvae or larval mites. It cannot be spread to your family members.

Treatment options are:

  1. Capsule Doxycycline 100 mg twice daily for seven days.

  2. Tablet Paracetamol 500 mg thrice daily for five days.

  3. Tablet Pantoprazole 40 mg once on an empty stomach in the morning for seven days.

Scrub typhus resolves within 7 to 10 days when antibiotics are started at the earliest.

Investigations to be done:

  1. Complete blood count.

  2. Dengue non-structural protein 1 (NS1).

  3. Peripheral smear (PS) for malarial parasites.

  4. Polymerase chain reaction (PCR).

  5. Alkaline phosphatase (ALP) levels.

  6. Alanine aminotransferase (ALT) levels.

  7. Aspartate aminotransferase levels.

Feel free to follow up with any further questions or concerns.

Thank you.

Answered byDr. Reema Wankar

Medically reviewed byiCliniq medical review team

Published At April 23, 2025
Reviewed AtApril 28, 2025

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Reema Wankar
Dr. Reema Wankar

Family Physician

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