What are the causes and symptoms of scrub typhus?
The incubation period of scrub typhus is about 10 to 12 days after the initial bite. The illness begins rather suddenly with shaking chills, fever, severe headache, infection of the mucous membrane lining the eyes (the conjunctiva), and swelling of the lymph nodes (lymphadenopathy). A wound (lesion) is often seen at the site of the chigger bite. Bite wounds are common in whites but rare in Asians. The initial lesion, which is about 1 cm (0.4 in) in diameter and flat, eventually becomes elevated and filled with fluid. After it ruptures, it becomes covered with a black scab (eschar). The patient’s fever rises during the first week, generally reaching 40–40.5°C (104–105°F). About the fifth day of fever, a red spotted rash develops on the trunk, often extending to the arms and legs. It may either fade away in a few days or may become spotted and elevated (maculopapular) and brightly colored. Cough is present during the first week of the fever. An infection of the lung (pneumonitis) may dev
