Orientia tsutsugamushi

1129:. However, it has spread to Africa, Europe and South America. One billion people are estimated to be at risk of infection at any moment and an average of one million cases occur every year in the Tsutsugamushi Triangle. The burden of scrub typhus in rural areas of Asia is huge, accounting for up to 20% of febrile sickness in hospital, and seroprevalence (positive infection on blood test) over 50% of the population. More than one-fifth of the population carry the bacterial antibodies, i.e. they had been infected, in endemic areas. South Korea has the highest level incidence (with its highest of 59.7 infections out of 100,000 people in 2013), followed by Japan, Thailand, and China at top of the list. The age group of 60–69 years is at highest risk of infection. Higher infection (57.3%) is seen in females compared to males (42.7%). Farmers are most vulnerable, accounting for 70% of the cases in China. The disease is more prevalent in rural areas, but there is a rapid increase in urban areas. For example, in Korea, the annual incidence increased 21-fold between 2003 and 2013 in metropolitan areas. 950:) having molecular weights 22 kDa, 47 kDa, 56 kDa and 110 kDa. A 56-kDa type specific antigen (TSA56) is the most important because it is not produced by any other bacteria, and is responsible for making the genetic diversity in different strains. It accounts for about 10–15% of the total cell proteins. The 22-kDa, 47-kDa or 110-kDa antigens are not strain specific so that TSA56 is the main target in sophisticated diagnostic tests such as immunoblotting, ELISA and DNA analysis. The protein assists the adhesion and entry of the bacterium into host cells, as well as evasion of the host's immune reaction. It varies in size from 516 to 540 amino acid residues between different strains, and its gene is approximately 1,550 base pairs long. Its gene contains four hypervariable regions, indicating that it synthesises many antigenically different proteins. There are also 11-kDa and 60-kDa proteins inside the bacterium which are very similar to 930:) in 1944. She observed that different strains had varying degree of virulence, and that the antibodies in the blood sera of patients cross-react to different strains. By 1946, she established that there were three principal strains (serotypes), namely Karp (from New Guinea), Gilliam (from India) and Seerangay (from British Malaya). Akira Shishido described the Kato strain, in addition to Gilliam and Karp, in Japan in 1958. Since then, six basic antigenic strains are recognised, namely Gilliam, Karp, Kato, Shimokoshi, Kawasaki, and Kuroki. Karp is the most abundant strain, accounting for about 50% of all infections. In Korea, the major strain is Boryong. As of 2009, more than 20 different strains have been established in humans based on 1282:. An infected individual may develop a short-term immunity but that disappears after a few months, and immunity to one strain does not confer immunity to another. An immunisation experiment was done in 1950 in which 16 volunteers still developed the infection after 11–25 months of primary infection. It is now known that the longevity of immunity depends on the strains of the bacterium. When reinfection occurs with the same strain as the previous infection, there can be immunity for 5–6 years in monkeys. But in humans, immunity declines after one year, and disappears within two years. 728:. It can be transmitted by a female to its eggs through the process called transovarial transmission, and from the eggs to larvae and adults through the process of transstadial transmission. Thus, the bacterial life cycle is maintained entirely in mites. Infection to rodents and humans is an accidental transmission from the bite of mite larvae, and not required for reproduction or survival of the bacterium. In fact, in humans the transmission is stopped, and the bacterium meets a dead end. However, uninfected mites can acquire the infection from infected rodents. 450: 1292: 579: 1104: 712: 1210:. Weil–Felix is the simplest and most rapid test, but it is not sensitive or specific, as it detects any kind of rickettsial infection. More sensitive tests such as rapid immunochromatographic test (RICT), immunofluorescence assays (IFA), ELISA, and DNA analysis using polymerase chain reaction (PCR) are used. IFA is regarded as the gold standard test, as it gives a reliable result; however, it is expensive and not specific for different rickettsial bacteria. ELISA and PCR can detect 33: 809: 911:) from an infected host cell is also unusual. It forms another vesicle using the host cell membrane, gives rise to a small bud, and releases itself from the host cell surface while still enclosed in the vesicle. The membrane-bound bacterium is formed by interaction between cholesterol-rich lipid rafts as well as HtrA, a 47-kDa protein on the bacterial surface. However, the process of budding and importance of the membrane-bound bacterium are not yet understood. 935:

mites. The different strains exert different levels of virulence, and the most virulent is KN-3, which is predominant among wild rodents. Another study in 1996 reported 40 strains. Genetic methods have revealed even greater complexity than had been previously described (for example, Gilliam is further divided into Gilliam and JG types). Due to immunological differences of the serotypes, simultaneous and repeated infection with different strains is possible.

373:) which he found on the ears of field mice could carry and transmit the infection. In 1917, Mataro Nagayo and colleagues gave the first complete description of the developmental stages such as egg, nymph, larva, and adult of the mite. They also asserted that only the larvae bites mammals, and are thus the only carriers of the parasites. But then, the actual infectious agent was not known, and it was generally attributed to either a virus or a protozoan. 660:, the most well-known member. The entire genome is distributed in a single circular chromosome. Whole genome sequences are available only for Ikeda and Boryong strains, both from the Republic of Korea. The genome of the Ikeda strain is 2,008,987 base pairs (bp) long, and contains 1,967 protein-coding genes. The Boryong strain is larger with 2,127,051 bp and 2,179 protein-coding genes. 1266:

An ideal vaccine should give protection to all the strains present locally. This complexity makes it difficult to produce a usable vaccine. A vaccine targeting the 47-kDa outer membrane protein (OMP) is a promising candidate with experimental success in mice against the Boryong strain. Combined targeting of TSA56 and ScaA is also a good candidate for mixed-strain infection.

251:. With highly variable membrane protein, a 56-kDa protein, the bacterium can be antigenically classified into many strains (sub-types). The classic strains are Karp (which accounts for about 50% of all infections), Gilliam (25%), Kato (less than 10%), Shimokoshi, Kuroki and Kawasaki. Within each strain, enormous variability further exists. 1178:) takes between 6 and 21 days. A simple visual diagnosis is the presence of an inflamed scar-like scab called eschar, which is regarded as "the most useful diagnostic clue in patients with acute febrile illness". Eschar is formed on the skin where an infected mite bit, usually seen in the armpit, groin or any abdominal area ( 1265:

vaccines are currently available. The first vaccines were developed in the late 1940s, but failed in clinical trials. Considered an ideal target, the unique TSA56 itself is highly variable in its chemical composition in different strains. An effective vaccine for one strain is not useful for another.

787:

are the principal natural hosts of the chiggers. Chiggers feed only once on a mammalian host. The feeding usually takes 2 to 4 days. In contrast to most parasites, they do not feed on blood, but instead on the body fluid through the hair follicles or skin pores. In the process of feeding, they create

1124:

Scrub typhus is historically endemic to the Asia-Pacific region, covering the Russian Far East and Korea in the north, to northern Australia in the south, and Afghanistan in the west, including islands of the western Pacific Oceans such as Japan, Taiwan, Philippines, Papua New Guinea, Indonesia, Sri

355:

Last summer , I had the opportunity of observing a disease which, so far as I know, is peculiar to Japan, and has not yet been, described. It occurs, moreover, in certain well-marked districts, and at a particular season of the year, so that the opportunities of investigating it do not often occur.

574:

encodes penicillin-binding protein-1 (PBP1), which converts periplasmic lipid II to peptidoglycan. Thus, the bacterium cannot synthesise a typical peptidoglycan cell wall, and instead makes a peptidoglycan-like structure on its surface. The cell membrane is also chemically different in its protein

847:

in all organs as the secondary targets. The parasite first attaches itself to the target cells using surface proteoglycans present on the host cell and bacterial surface proteins such as type specific protein 56 (or type specific antigen, TSA56) and surface cell antigens (ScaA and ScaC, which are

270:

is a good indicator of infection, but is not ubiquitous. The bacterium is endemic to the so-called Tsutsugamushi Triangle, a region covering the Russian Far East in the north, Japan in the east, northern Australia in the south, and Afghanistan in the west. One million infections are estimated to

1026:

and lungs. The disease is responsible for nearly a quarter of all the febrile (high fever) illness in endemic areas. Mortality in severe cases or due to improper treatment or misdiagnosis may be as high as 30–70%. About 6% of infected people die untreated, and 1.4% of the patients die even with

934:

using serological tests such as complement fixation and immunofluorescence assay. The number is much higher if the strains in rodents and mites are taken into account. For example, a study in Japan in 1994 reported 32 strains, 14 from human patients, 12 from wild rodents, and 6 from trombiculid

1119:

Scrub typhus is probably one of the most underdiagnosed and underreported febrile illnesses requiring hospitalization in the region. The absence of definitive signs and symptoms combined with a general dependence upon serological tests make the differentiation of scrub typhus from other common

1253:, and azithromycin is the drug of choice. In Southeast Asia, where doxycycline and chloramphenicol resistance have been experienced, azithromycin is recommended for all patients. A randomized controlled trial and systematic review showed that azithromycin is the safest medication. 364:

The aetiology of the disease was unknown until the early 20th century. In 1908, a mite theory of the transmission of tsutsugamushi disease was postulated by Taichi Kitashima and Mikinosuke Miyajima. In 1915, a British zoologist, Stanley Hirst, suggested that the larvae of mite

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Shishido, A.; Ohtawara, M.; Tateno, S.; Mizuno, S.; Ogura, M.; Kitaoka, M. (1958). "The nature of immunity against scrub typhus in mice i. the resistance of mice, surviving subcutaneous infection of scrub typhus rickettsia, to intraperitoneal reinfection of the same agent".

1005:

causes a complex and potentially life-threatening disease known as scrub typhus. Infection starts when chiggers bite on the skin during their feeding. The bacteria are deposited at the site of feeding (inoculation), where they multiply. They cause progressive tissue damage

520:

species. A capsule layer that forms a spherical halo in other bacteria is missing. The cell wall is less rigid due to the absence of peptidoglycan, which is otherwise characteristic of the rigid cell walls of other bacteria. Classic bacterial lipophosphoglycans such as

1027:

medical treatment. Moreover, the death rate can be as high as 14% with neurological problems and 24% with multi-organ dysfunction among treated patients. In cases of misdiagnosis and failure of treatment, systemic complications rapidly develop including

1067:. Harmful effects involving multiple organ failure and neurological impairment are difficult to treat, and can cause lifelong debilitation or be directly fatal. The central nervous system is often affected and results in various complications including 1091:. Death rates due to complications can be up to 14% in brain infections, and 24% with multiple organ failure. In India, scrub typhus has become the major cause of acute encephalitis syndrome, which was earlier caused mainly by a viral infection, 2639:

Cho, N.-H.; Kim, H.-R.; Lee, J.-H.; Kim, S.-Y.; Kim, J.; Cha, S.; Kim, S.-Y.; Darby, A. C.; Fuxelius, H.-H.; Yin, J.; Kim, J. H.; Kim, J.; Lee, S. J.; Koh, Y.-S.; Jang, W.-J.; Park, K.-H.; Andersson, S. G. E.; Choi, M.-S.; Kim, I.-S. (2007).

4328:

Mørch, K.; Manoharan, A.; Chandy, S.; Chacko, N.; Alvarez-Uria, G.; Patil, S.; Henry, A.; Nesaraj, J.; Kuriakose, C.; Singh, A.; Kurian, S.; Gill Haanshuus, C.; Langeland, N.; Blomberg, B.; Vasanthan Antony, G.; Mathai, D. (2017).

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Bakshi, D.; Singhal, P.; Mahajan, S.K.; Subramaniam, P.; Tuteja, U.; Batra, H.V. (2007). "Development of a real-time PCR assay for the diagnosis of scrub typhus cases in India and evidence of the prevalence of new genotype of

887:. It then moves towards the nucleus, specifically at the perinuclear region, where it starts to grow and multiply. Unlike other closely related bacteria which use actin-mediated processes for movement in the cytoplasm (called 376:

The causative pathogen was first identified by Naosuke Hayashi in 1920. Confident that the organism was a protozoan, Hayashi concluded, stating, "I have reached the conclusion that the virus of the disease is the species of

360:, or island-insect disease, and is so-named from the belief that it is caused by the bite or sting of some insect peculiar to certain islands in the river known as Shinagawa, which empties itself into the sea at Niigata. 1186:. But, the problem is that eschar is not always present; at the highest record, only 55% of scrub typhus patients had eschar during an outbreak in south India. Also, eschar is not specific to scrub typhus, occurring in 418:. Kawamüra and Imagawa discovered that the bacteria are stored in the salivary glands of mites, and that mites feed on body (lymph) fluid, thereby establishing the fact that mites transmit the parasites during feeding. 549:

species are normally sensitive to. Its genome totally lacks the genes for lipophosphoglycan synthesis, but does contain some for those of peptidoglycan. Important genes essential for peptidoglycan synthesis such as

257:

is naturally maintained in the mite population by transmission from female to its eggs (transovarial transmission), and from the eggs to larvae and then to adults (transtadial transmission). The mite larvae, called

781:), are the only ectoparasitic stage feeding on the body fluids of rodents and other opportunistic mammals. Thus, they are the only stage in the life of mites that transmit the infection. Wild rats of the genus 870:

has a special adaptation for surviving in the host cell by evading the host immune reaction. Once it interacts with the host cells, it causes the host cell membrane to form a transportation bubble called a

2583:

Nakayama, K.; Yamashita, A.; Kurokawa, K.; Morimoto, T.; Ogawa, M.; Fukuhara, M.; Urakami, H.; Ohnishi, M.; Uchiyama, I.; Ogura, Y.; Ooka, T.; Oshima, K.; Tamura, A.; Hattori, M.; Hayashi, T. (2008).

7035: 485:. It is broader but shorter than other rickettsial bacteria, which are rod shaped and on average measure 0.25 to 0.3 μm wide and 0.8 to 1 μm long. During reproduction, it divides (by 489:) into two daughter cells by the process of budding. While undergoing budding, it accumulates on the host cell surface, unlike other bacteria. One complete budding cycle takes 9 to 18 hours. 224:

infection was first reported in Japan by Hakuju Hashimoto in 1810, and to the Western world by Theobald Adrian Palm in 1878. Naosuke Hayashi first described it in 1920, giving the name

7020: 7025: 5318: 4917:

Chanta, C.; Phloenchaiwanit, P. (2015). "Randomized Controlled trial of azithromycin versus doxycycline or chloramphenicol for treatment of uncomplicated pediatric scrub typhus".

3825:

Arai, S.; Tabara, K.; Yamamoto, N.; Fujita, H.; Itagaki, A.; Kon, M.; Satoh, H.; Araki, K.; Tanaka-Taya, K.; Takada, N.; Yoshikawa, Y.; Ishihara, C.; Okabe, N.; Oishi, K. (2013).

777:

is also a major vector. The life cycle of mites consists of egg, prelarva, larva, protonymph, deutonymph, tritonymph, and adult. The larvae, commonly referred to as chiggers (

315:

infection was in the 3rd century (313 C.E.) in China. Japanese were also familiar with the link between the infection and mites for centuries. They gave several names such as

1194:, Brazilian spotted fever, and Indian tick typhus. Using DNA analysis by advanced polymerase chain reaction, different rickettsial infections can be identified from eschars. 1617:"Some account of a disease called "shima-mushi," or "island-insect disease," by the natives of Japan; peculiar, it is believed, to that country, and hitherto not described" 1170:. This makes precise clinical diagnosis difficult, which often leads to misdiagnosis. The initial indications are fever with chills, associated with headache, muscle pain ( 1214:-specific proteins such as the TSA56 and GroEL, so that they are highly specific and sensitive. On the other hand, they are highly sophisticated and expensive techniques. 695:–containing protein. Ankyrin repeat–containing proteins are secreted through a type I secretion system into the host cell. The precise role of type IV secretion system in 471:. A unicellular organism, it is oval shaped and measures 0.5 to 0.8 μm wide and 1.2 to 3.0 μm long. Due to similarity, it was previously classified in the genus 2703:

Batty, E.M.; Chaemchuen, S.; Blacksell, S.; Richards, A.L.; Paris, D.; Bowden, R.; Chan, C.; Lachumanan, R.; Day, N.; Donnelly, P.; Chen, S.; Salje, J.; Reck, J. (2018).

214:

among bacterial genomes sequenced so far. The disease, scrub typhus, occurs when infected mite larvae accidentally bite humans. This infection can prove fatal if prompt

1249:. Doxycycline is the most commonly used and is considered as the drug of choice because of its high efficacy and quick action. But, in pregnant women and babies, it is 4472:

Varghese, G.M.; Janardhanan, J.; Trowbridge, P.; Peter, J.V.; Prakash, J.A.; Sathyendra, S.; Thomas, K.; David, T.S.; Kavitha, M.L.; Abraham, O.C.; Mathai, D. (2013).

4206: 4380:

Wangrangsimakul, T.; Althaus, T.; Mukaka, M.; Kantipong, P.; Wuthiekanun, V.; Chierakul, W.; Blacksell, S.D.; Day, N.P.; Laongnualpanich, A.; Paris, D.H. (2018).

6966: 383:

in question... I consider the organism in Tsutsugamushi disease as a hitherto undescribed species, and at the suggestion of Dr. Henry B. Ward designate it as

4560:

Silva, N.; Eremeeva, M.E.; Rozental, T.; Ribeiro, G.S.; Paddock, C.D.; Ramos, E.A.; Favacho, A.R.; Reis, M.G.; Dasch, G.A.; de Lemos, E.R.; Ko, A.I. (2011).

792:, which is a tube formed by solidified saliva. Their saliva can dissolve the host tissue around the feeding site, so that they ingest the liquefied tissue. 5311: 5205:

MacMillan, J.G.; Rice, R.M.; Jerrells, T.R. (1985). "Development of antigen-specific cell-mediated immune responses after infection of cynomolgus monkeys (

4944:

Lee, S.C.; Cheng, Y.J.; Lin, C.H.; Lei, W.T.; Chang, H.Y.; Lee, M.D.; Liu, J.M.; Hsu, R.J.; Chiu, N.C.; Chi, H.; Peng, C.C.; Tsai, T.L.; Lin, C.Y. (2017).

575:

composition, and this difference gives rise to strain variations within the species itself. The cytoplasm is clear and shows distinct DNA and ribosomes.

4513:

Kelman, P.; Thompson, C.W.; Hynes, W.; Bergman, C.; Lenahan, C.; Brenner, J.S.; Brenner, M.G.; Goodman, B.; Borges, D.; Filak, M.; Gaff, H. (2018). "

516:. Although its cell wall has a classic bacterial double layer, its outer leaflet is much thicker than the inner one, which is just the opposite in 6940: 5304: 3332:

Bengston, I.A. (1946). "A serological study of 37 cases of tsutsugamushi disease (scrub typhus) occurring in Burma and the Philippine Islands".

1518:

Yamamoto, S.; Kawabata, N.; Tamura, A.; Urakami, H.; Ohashi, N.; Murata, M.; Yoshida, Y.; Kawamura A, Jr. (1986). "Immunological properties of

6979: 2344:

Atwal, S.; Giengkam, S.; Chaemchuen, S.; Dorling, J.; Kosaisawe, N.; VanNieuwenhze, M.; Sampattavanich, S.; Schumann, P.; Salje, J. (2017).

2530:

Bishop-Lilly, K.A.; Ge, H.; Butani, A.; Osborne, B.; Verratti, K.; Mokashi, V.; Nagarajan, N.; Pop, M.; Read, T.D.; Richards, A.L. (2013).

1565:

Fan, M.Y.; Walker, D.H.; Yu, S.R.; Liu, Q.H. (1987). "Epidemiology and ecology of rickettsial diseases in the People's Republic of China".

2817:

Takhampunya, R.; Korkusol, A.; Promsathaporn, S.; Tippayachai, B.; Leepitakrat, S.; Richards, A.L.; Davidson, S.A.; Small, P.L.C. (2018).

437:. Finally, in 1995, they made a new classification based on the morphological and biochemical properties, formally creating the new name 7030: 1827:

Nagayo, M.; Tamiya, T.; Mitamura, T.; Sato, K. (1930). "On the virus of tsutsugamushi disease and its demonstration by a new method".

570:

encodes diaminopimelate epimerase, which convert LL-2,6-diaminoheptanedioate (L,L-DAP) to meso-diaminoheptanedioate (meso-DAP); and

6927: 2924:

Luce-Fedrow, A.; Lehman, M.; Kelly, D.; Mullins, K.; Maina, A.; Stewart, R.; Ge, H.; John, H.; Jiang, J.; Richards, Allen (2018).

566:

encodes an enzyme L-alanine racemase, which converts L-alanine to D-alanine in the first step of peptidoglycan synthesis pathway;

6953: 1313: 3470:

strains among humans, wild rodents, and trombiculid mites in an area of Japan in which tsutsugamushi disease is newly endemic"

610:. Unlike other bacteria which can easily grow on different culture media, rickettsiales can be cultured only in living cells. 6484: 3520:

Ohashi, N.; Koyama, Y.; Urakami, H.; Fukuhara, M.; Tamura, A.; Kawamori, F.; Yamamoto, S.; Kasuya, S.; Yoshimura, K. (1996).

1304: 6958: 6134: 5879: 5178:

Smadel, JE; Ley, H.L.Jr.; Diercks, F.H.; Traub, R. (1950). "Immunity in scrub typhus: resistance to induced reinfection".

4214: 875:

by which it gets transported into the cytoplasm. Inside the cytoplasm, it makes an exit from the vesicle (now known as an

7045: 1064: 1028: 923: 680: 5560: 4150:

Jain, P.; Prakash, S.; Tripathi, P.K.; Chauhan, A.; Gupta, S.; Sharma, U.; Jaiswal, A.K.; Sharma, D.; Jain, A. (2018).

3613:

Parola, P.; Blacksell, S.D.; Phetsouvanh, R.; Phongmany, S.; Rolain, J.M.; Day, N.P.; Newton, P.N.; Raoult, D. (2008).

606:

The bacterium is highly virulent, such that its isolation and cell culture are done only in a laboratory facility with

1125:

Lanka, and the Indian Subcontinent. This geographic region is popularly called the Tsutsugamushi Triangle as shown in

5688: 5331: 4056:

Rajapakse, S.; Weeratunga, P.; Sivayoganathan, S.; Fernando, S.D. (2017). "Clinical manifestations of scrub typhus".

3725:: molecular cloning and sequence analysis of the sta56 gene and precise identification of a strain-specific epitope" 663:

Genome comparison shows only 657 core genes among the different strains. With about 42-47% of repetitive sequences,

6892: 6124: 3281:

Bengston, I.A. (1945). "Apparent serological heterogeneity among strains of Tsutsugamushi disease (scrub typhus)".

1146:

infection is high (febrile) fever; however, the symptom is similar to other vector-borne tropical diseases such as

497: 6129: 5670: 614:

specifically can be grown only in the yolk sacs of developing chicken embryos and in cultured cell lines such as

429:

were equally used. Akira Tamura and colleagues reported in 1991 the structural differences of the bacterium from

6984: 5702: 5296: 6792: 683:

called the rickettsial amplified genetic element (RAGE). RAGE is also found in other rickettsial bacteria. In

5518: 5028:

Berge, T.O.; Gauld, R.L.; Kitaoka, M. (1949). "A field trial of a vaccine prepared from the Volner strain of

2646:

genome reveals massive proliferation of conjugative Type IV secretion system and host-cell interaction genes"

667:

has the most highly repeated bacterial genome sequenced as of 2013. The repeated DNA sequence includes short

6688: 6012: 5448: 5248:

Ha, N.Y.; Kim, Y.; Min, C.K.; Kim, H.I.; Yen, N.T.H.; Choi, M.S.; Kang, J.S.; Kim, Y.S.; Cho, N.H. (2017).

1191: 839:. In the blood circulation, it targets professional phagocytes ("cell eaters", white blood cells) such as 6349: 6343: 5959: 463:

is a Gram-negative bacterium and is a permanent (obligate) parasite in mites. Within a single host cell,

643: 266:

of rodents. Humans get infected upon accidental contact with infected chiggers. A scar-like scab called

6428: 4474:"Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome" 2116:

Sunyakumthorn, P.; Bourchookarn, A.; Pornwiroon, W.; David, C.; Barker, S. A.; Macaluso, K. R. (2008).

1846:

Nagayo, M.; Tamiya, T.; Mitamura, T.; Sato, K. (1930). "Sur le virus de la maladie de Tsutsugamushi ".

1656:

Miyajima, M.; Okumura, T. (1917). "On the life cycle of the "Akamushi" carrier of Nippon river fever".

4382:"Causes of acute undifferentiated fever and the utility of biomarkers in Chiangrai, northern Thailand" 287:

are also effective. Diagnosis of the infection is difficult and requires laborious techniques such as

6149: 5984: 5953: 5883: 5664: 5406: 3778:: sequence homology and antigenic comparison of Sta58 to the 60-kilodalton family of stress proteins" 1112: 300: 1278:

infection. Antigenic variation prevents the development of cross immunity to the various strains of

6624: 6527: 6406: 6144: 6139: 6023: 5812: 5631: 5554: 5546: 1934:

Kawamüra, R.; Imagawa, Y. (1931). "Die feststellung des erregers bei der tsutsugamushikrankheit ".

927: 733: 700: 654:), which is comparatively larger than those of other rickettsiales – two times larger than that of 619: 7040: 6828: 6708: 6668: 6610: 6329: 6096: 5532: 5490: 4331:"Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy" 3242:

Kim, M.J.; Kim, M.K.; Kang, J.S. (2013). "Involvement of lipid rafts in the budding-like exit of

2705:"Long-read whole genome sequencing and comparative analysis of six strains of the human pathogen 888: 856:(the process of ingesting the bacterium). The ability to actually enter the host cell depends on 668: 587: 211: 1308: 339:

meaning bug or insect). Japanese physician Hakuju Hashimoto gave the first medical account from

7050: 6945: 6854: 6644: 6562: 6521: 6517: 6398: 6392: 6159: 5869: 5804: 5504: 5476: 5410: 1088: 404: 400: 203: 1022:. Within a few days, vasculitis extends to various organs including the liver, brain, kidney, 6661: 6650: 6448: 6078: 5904: 5875: 5682: 5442: 5396: 4813:

Patricia, K.A.; Hoti, S.L.; Kanungo, R.; Jambulingam, P.; Shashikala, N.; Naik, A.C. (2017).

4281:"Unresolved problems related to scrub typhus: A seriously neglected life-threatening disease" 1300: 1092: 988:

with slight variation in different strains, and they produce the 11-kDa and 60-kDa proteins.

926:

was the first to note the existence of different strains using antigen-antibody interaction (

672: 656: 347:. The first report to the Western world was made by Theobald Adrian Palm, a physician of the 343:

in 1810. He recorded the prevalence of infection along the banks of the upper tributaries of

292: 140: 6997: 3081:

Ha, N.Y.; Sharma, P.; Kim, G.; Kim, Y.; Min, C.K.; Choi, M.S.; Kim, I.S.; Cho, N.H. (2015).

646:

among bacteria generally results in a reduced genome, it has a genome size of about 2.0–2.7

6914: 6822: 6782: 6735: 6617: 6268: 6226: 6206: 6163: 6019: 5818: 5498: 2771: 2657: 2133: 1107:

Map showing the Tsutsugamushi Triangle. Countries with human cases are labeled with a star.

1060: 904: 675:(including insertion sequence elements, miniature inverted-repeat transposable elements, a 627: 4611:"Indian tick typhus presenting as purpura fulminans with review on rickettsial infections" 2823:

genotypes in field-collected trombiculid mites from wild-caught small mammals in Thailand"

508:

on the outside and cell membrane on the inside. The cell covering takes up stains such as

8: 6800: 6745: 6414: 6290: 6235: 6183: 6102: 6045: 5998: 5933: 5781: 5773: 5767: 5484: 5470: 5339: 4993:

Card, W.I.; Walker, J.M. (1947). "Scrub-typhus vaccine; field trial in South-east Asia".

2491:

and the relationship among its antigenic variants by analyses of 16S rRNA gene sequences"

1207: 1084: 1076: 973: 931: 533:, and 2-keto-3-deoxyoctonic acid are also absent in the cell wall. Due to the absence of 288: 173: 82: 3893:"Severe scrub typhus infection: Clinical features, diagnostic challenges and management" 2775: 2661: 2137: 1120:

febrile diseases such as murine typhus, typhoid fever and leptospirosis quite difficult.

6788: 6699: 6200: 6189: 6110: 6054: 5842: 5540: 5526: 5456: 5433: 5278: 5249: 5155: 5126: 5102: 5071: 5045: 4970: 4945: 4894: 4867: 4843: 4814: 4795: 4741: 4704: 4685: 4673: 4637: 4610: 4586: 4561: 4542: 4408: 4381: 4357: 4330: 4305: 4280: 4256: 4229: 4182: 4151: 4127: 4100: 4081: 4030: 4003: 3974: 3943: 3919: 3892: 3863: 3826: 3643: 3614: 3555: 3542: 3521: 3441: 3412: 3393: 3349: 3314: 3298: 3219: 3190: 3166: 3137: 3113: 3082: 3010: 2983: 2956: 2925: 2849: 2818: 2794: 2759: 2735: 2704: 2680: 2641: 2613: 2584: 2560: 2531: 2507: 2486: 2462: 2437: 2374: 2345: 2154: 2117: 2093: 2060: 1985: 1809: 1732: 1699: 1633: 1616: 1547: 1535: 1452: 1404: 1373: 969: 832: 638:

mostly grows within the cytoplasm of the host cell. Genetically, it differs from other

348: 340: 296: 47: 6971: 5006: 4834: 3802: 3773: 3749: 3720: 3696: 3667: 3591: 3494: 3465: 3189:

Ko, Y.; Choi, J.H.; Ha, N.Y; Kim, I.S.; Cho, N.H.; Choi, M.S.; Bäumler, A. J. (2013).

2321: 2292: 2268: 2231: 2207: 2178: 6992: 6901: 6773: 6739: 6603: 6535: 6298: 6276: 6245: 5696: 5462: 5283: 5230: 5187: 5160: 5107: 5049: 5010: 4975: 4926: 4899: 4868:"DHR-ICMR Guidelines for diagnosis & management of rickettsial diseases in India" 4848: 4787: 4746: 4717:

in skin biopsy specimens using a multiplex real-time polymerase chain reaction assay"

4677: 4642: 4591: 4534: 4495: 4454: 4413: 4362: 4310: 4261: 4187: 4132: 4073: 4035: 3979: 3924: 3868: 3807: 3754: 3701: 3648: 3595: 3547: 3499: 3485: 3446: 3357: 3306: 3263: 3224: 3171: 3118: 3060: 3015: 2961: 2903: 2854: 2799: 2740: 2685: 2618: 2565: 2512: 2467: 2379: 2326: 2273: 2212: 2159: 2098: 2041: 1977: 1737: 1638: 1582: 1539: 1500: 1444: 1440: 1409: 1342: 1175: 591: 244: 200: 6217: 6174: 6069: 4689: 4546: 3793: 3740: 3559: 3397: 3318: 2312: 2259: 2198: 1989: 1456: 1291: 602:(1000bp windows) with above-median region in green, and below-median regions in red. 399:

is a causative bacterium of epidemic typhus first discovered by American physicians

6906: 6764: 6679: 6470: 6317: 6304: 6119: 5736: 5718: 5625: 5584: 5512: 5382: 5273: 5265: 5222: 5150: 5142: 5125:

Choi, S.; Jeong, H.J.; Hwang, K.J.; Gill, B.; Ju, Y.R.; Lee, Y.S.; Lee, J. (2017).

5097: 5087: 5041: 5002: 4965: 4957: 4889: 4879: 4838: 4830: 4777: 4736: 4728: 4669: 4632: 4622: 4581: 4573: 4526: 4485: 4444: 4403: 4393: 4352: 4342: 4300: 4292: 4251: 4241: 4177: 4167: 4122: 4112: 4085: 4065: 4025: 4015: 3969: 3959: 3914: 3904: 3858: 3850: 3797: 3789: 3744: 3736: 3691: 3683: 3638: 3630: 3587: 3537: 3489: 3481: 3436: 3428: 3385: 3341: 3290: 3255: 3214: 3206: 3161: 3153: 3108: 3098: 3050: 3005: 2995: 2951: 2941: 2893: 2844: 2834: 2789: 2779: 2730: 2720: 2675: 2665: 2608: 2600: 2555: 2547: 2502: 2457: 2449: 2413: 2401: 2369: 2361: 2316: 2308: 2263: 2255: 2202: 2194: 2149: 2141: 2088: 2080: 2031: 1969: 1801: 1768: 1756: 1727: 1719: 1628: 1574: 1551: 1531: 1490: 1479:"Scrub typhus: the geographic distribution of phenotypic and genotypic variants of 1436: 1399: 1389: 1350: 1332: 1250: 960: 4660:

Walker, D.H. (1989). "Rickettsioses of the spotted fever group around the world".

3687: 3259: 1789: 6714: 6635: 6589: 6494: 6434: 6369: 6311: 6280: 6272: 5975: 5945: 5939: 5822: 5651: 5575: 5402: 4799: 4398: 4172: 4020: 3964: 3103: 3055: 3034: 3000: 2839: 2784: 2725: 1936:

Zentralblatt für Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene

1894:

Zentralblatt für Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene

1394: 1230: 1019: 797: 724: 676: 607: 449: 280: 5326: 5127:"A recombinant 47-kDa outer membrane protein induces an immune response against 4961: 4766:"Diagnostic validation of selected serological tests for detecting scrub typhus" 2982:

Xu, G.; Walker, D.H.; Jupiter, D.; Melby, P.C.; Arcari, C.M.; Day, N.P. (2017).

2536:, the causative agent of epidemic typhus, including one flying squirrel isolate" 6877: 6814: 6464: 6458: 6321: 6059: 5590: 5357: 5327: 5250:"Longevity of antibody and T-cell responses against outer membrane antigens of 5226: 4490: 4473: 4246: 3432: 2946: 2453: 840: 692: 486: 192: 106: 70: 4530: 4347: 2291:

Amano, K.; Tamura, A.; Ohashi, N.; Urakami, H.; Kaya, S.; Fukushi, K. (1987).

2036: 2007: 1578: 1014:

on the skin. Necrosis progresses to inflammation of the blood vessels, called

711: 7014: 6810: 6726: 6553: 6508: 6249: 6241: 6084: 5851: 5762: 5616: 5422: 5388: 5363: 5348: 5092: 4884: 4627: 4449: 4432: 3526:

which were isolated in Japan, and their classification into type and subtype"

3389: 2551: 2418: 1773: 1346: 1242: 1187: 1159: 1155: 1151: 534: 513: 344: 248: 233: 207: 94: 4782: 4765: 4117: 4069: 3909: 3774:"Molecular cloning and sequence analysis of the Sta58 major antigen gene of 2898: 2873: 2670: 2604: 1337: 1320: 6806: 6580: 5787: 5727: 5674: 5659: 5604: 5287: 5191: 5164: 5111: 5053: 5014: 4979: 4930: 4903: 4852: 4791: 4750: 4646: 4595: 4577: 4538: 4499: 4458: 4417: 4366: 4314: 4265: 4191: 4136: 4077: 4039: 3983: 3928: 3872: 3652: 3634: 3599: 3450: 3361: 3310: 3267: 3228: 3175: 3122: 3064: 3019: 2965: 2907: 2858: 2816: 2803: 2744: 2689: 2622: 2569: 2471: 2436:

Koh, G.C.; Maude, R.J.; Paris, D.H.; Newton, P.N.; Blacksell, S.D. (2010).

2383: 2163: 2102: 1741: 1642: 1504: 1448: 1413: 1226: 1167: 1068: 1056: 1048: 1032: 997: 900: 853: 578: 522: 509: 421:

For more than 60 years there was no consensus on the choice of name – both

379: 272: 196: 5234: 5146: 4681: 4431:

Kundavaram, A.P.; Jonathan, A.J.; Nathaniel, S.D.; Varghese, G.M. (2013).

4296: 3854: 3811: 3758: 3705: 3551: 3503: 2516: 2330: 2216: 2045: 1981: 1911:

Kawamüra, R.; Imagawa, Y. (1931). "Ueber die Proliferation der pathogenen

1586: 1543: 1354: 414:, while Rinya Kawamüra and Yoso Imagawa independently introduced the name 6886: 6380: 6335: 6286: 5990: 5742: 5269: 4732: 4055: 3719:

Stover, CK; Marana, DP; Carter, JM; Roe, BA; Mardis, E; Oaks, EV (1990).

3210: 3157: 2277: 2145: 2084: 1723: 1246: 1234: 1163: 1103: 1044: 896: 879:) before the endosome is destroyed (in the process of cell-eating called 849: 844: 828: 808: 538: 526: 284: 276: 215: 32: 3142:

is mediated by integrin signaling and actin cytoskeleton rearrangements"

2758:

Viswanathan, S.; Muthu, V.; Iqbal, N.; Remalayam, B.; George, T (2013).

2115: 1427:

Watt, G.; Parola, P. (2003). "Scrub typhus and tropical rickettsioses".

1378:: A neglected but fascinating obligate intracellular bacterial pathogen" 1307:). The updated content was reintegrated into the Knowledge page under a 773:

in Malaysia and Indonesia. In parts of India, a different mite species,

6932: 5754: 4866:

Rahi, M.; Gupte, M.D.; Bhargava, A.; Varghese, G.Mm; Arora, R. (2015).

4002:

Bonell, A.; Lubell, Y.; Newton, P.N.; Crump, J.A.; Paris, D.H. (2017).

3353: 3302: 1973: 1813: 1238: 1080: 1040: 1015: 908: 789: 722:

is naturally transmitted in the mite population belonging to the genus

599: 595: 542: 473: 391:, Mataro Nagayo and colleagues gave a new classification with the name 263: 240: 3136:

Cho, B. A.; Cho, N. H.; Seong, S. Y.; Choi, M. S.; Kim, I. S. (2010).

2589:

revealed massive gene amplification during reductive genome evolution"

2365: 848:

membrane transporter proteins). These proteins interact with the host

403:

and Russell M. Wilder in 1910, and described by a Brazilian physician

351:

at Niigata in 1878. Describing his first-hand experience, Palm wrote:

6568: 6420: 6088: 6029: 5910: 4946:"Comparative effectiveness of azithromycin for treating scrub typhus" 4379: 3891:

Peter, J.V.; Sudarsan, T.I.; Prakash, J.A.J.; Varghese, G.M. (2015).

2585:"The whole-genome sequencing of the obligate intracellular bacterium 1052: 1036: 880: 824: 647: 623: 505: 410:

The taxonomic confusion worsened. In 1931, Norio Ogata gave the name

188: 6848: 3464:

Yamashita, T.; Kasuya, S.; Noda, N.; Nagano, I.; Kang, J.S. (1994).

3345: 3294: 1805: 6871: 6004: 4430: 3666:

Tamura, A; Ohashi, N; Urakami, H; Takahashi, K; Oyanagi, M (1985).

3612: 3411:

Jang, M.S.; Neupane, G.P.; Lee, Y.M.; Kim, D.M.; Lee, S.H. (2011).

2179:"Growth characteristics and proteins of plaque-purified strains of 1956:

Tamura, A.; Urakami, H.; Ohashi, N. (1991). "A comparative view of

1495: 1478: 1023: 1007: 947: 884: 876: 872: 857: 827:(young white blood cells) in the area of inoculation, and then the 800:

of mites and is released into the host tissue during this feeding.

259: 236: 119: 58: 4703:

Denison, A.M.; Amin, B.D.; Nicholson, W.L.; Paddock, C.D. (2014).

4471: 4230:"Scrub typhus: No longer restricted to the Tsutsugamushi Triangle" 4058:

Transactions of the Royal Society of Tropical Medicine and Hygiene

2402:"Rickettsiosis as a critical emerging infectious disease in India" 2293:"Deficiency of peptidoglycan and lipopolysaccharide components in 1757:"The saga of scrub typhus with a note on the outbreaks in Mizoram" 6595: 6541: 5895: 5860: 3668:"Analysis of polypeptide composition and antigenic components of 2582: 1171: 1147: 1072: 899:-mediated processes similar to those employed by viruses such as 530: 4213:. World Health Organization, Geneva. p. 124. Archived from 2702: 6919: 5373: 3944:"A systematic review of mortality from untreated scrub typhus ( 3572: 1829:

Jikken Igaku Zasshi (Japanese Journal of Experimental Medicine)

1477:

Kelly, D.J.; Fuerst, P.A.; Ching, W.M.; Richards, A.L. (2009).

1011: 783: 715:

Chigger with its stylostome (arrowhead), the feeding apparatus.

433:

species that warranted a separate genus, and proposed the name

267: 7036:

Knowledge articles published in peer-reviewed literature (W2J)

4812: 4562:"Eschar-associated spotted fever rickettsiosis, Bahia, Brazil" 4156:

as an important cause of acute encephalitis syndrome in India"

3942:

Taylor, A.J.; Paris, D.H.; Newton, P.N.; Walker, D.H. (2015).

2760:"Scrub typhus meningitis in South India—a retrospective study" 2757: 2343: 1865:

da Rocha Lima, H. (1916). "Untersuchungen über fleckfleber ".

1604:. Cincinnati, OH (USA): Spokesman Printing Company. p. 2. 1018:. This in turn causes inflammation of the lymph nodes, called 327:(hairy mite) disease of northern Japan, and most popularly as 2923: 1517: 955: 951: 861: 4763: 4559: 4279:

Walker, D.H.; Paris, D.H.; Day, N.P.; Shelite, T.R. (2013).

4004:"Estimating the burden of scrub typhus: A systematic review" 3890: 3772:

Stover, C.K.; Marana, D.P.; Dasch, G.A.; Oaks, E.V. (1990).

3665: 3374: 2232:"Comparative ultrastructural study on the cell envelopes of 1915:

im tierischen organismus bei der tsutsugamushi-krankheit ".

1182:). In rare cases, it can be seen on the cheek, ear lobe and 4764:

Koraluru, M.; Bairy, I.; Varma, M.; Vidyasagar, S. (2015).

4702: 3519: 2529: 2484: 2005: 1884:

Ogata, N. (1931). "Aetiologie der Tsutsugamushi-krankheit:

1202:

Suspected infections are confirmed with serological tests.

1183: 615: 477:

among other bacteria, but later assigned a separate genus,

184: 4512: 4433:"Eschar in scrub typhus: a valuable clue to the diagnosis" 4327: 4149: 2878:

as the vector of scrub typhus outbreak in Darjeeling: Has

2485:

Ohashi, N.; Fukuhara, M.; Shimada, M.; Tamura, A. (1995).

2006:

Tamura, A.; Ohashi, N.; Urakami, H.; Miyamura, S. (1995).

586:

strains. From outermost to innermost ring of each genome:

4865: 4207:"WHO Recommended Surveillance Standards (Second edition)" 3672:

by polyacrylamide gel electrophoresis and immunoblotting"

3463: 2872:

Tilak, R.; Wankhade, U.; Kunwar, R.; Tilak, V.W. (2011).

1319:

Kholhring Lalchhandama; et al. (13 September 2019).

922:

is a diverse species of bacteria. Ida A. Bengtson of the

7021:

Knowledge articles published in peer-reviewed literature

3824: 2871: 2290: 1845: 1826: 1476: 691:

genes typical of type IV secretion systems and gene for

7026:

Knowledge articles published in WikiJournal of Medicine

4517:

infections diagnosed by eschar biopsy, Virginia, USA".

4001: 3941: 3522:"Demonstration of antigenic and genotypic variation in 1602:

Studies on tsutsugamushi disease (Japanese Blood Fever)

1522:, Kawasaki strain, isolated from a patient in Kyushu". 4815:"Improving the diagnosis of scrub typhus by combining 3413:"Phylogenetic analysis of the 56 kDa protein genes of 1174:), sweating and vomiting. The appearance of symptoms ( 634:

species which reside in the nucleus of the host cell,

5204: 5177: 5135:

The American Journal of Tropical Medicine and Hygiene

4916: 4285:

The American Journal of Tropical Medicine and Hygiene

4278: 3771: 3718: 3421:

The American Journal of Tropical Medicine and Hygiene

2984:"A review of the global epidemiology of scrub typhus" 2442:

The American Journal of Tropical Medicine and Hygiene

687:, however, RAGE contains a number of genes including 2981: 1848:

Comptes Rendus des Séances de la Société de Biologie

210:. With a genome of only 2.0–2.7 Mb, it has the most 2435: 1955: 1321:"Orientia tsutsugamushi, the agent of scrub typhus" 387:." Discovering the similarities with the bacterium 5124: 4608: 3087:provides protective immunity against scrub typhus" 1225:infection can be treated with antibiotics such as 1206:is most often detected from blood serum using the 753:are also carriers in many countries. In addition, 467:rapidly divides into many individuals as shown in 5027: 4101:"Neuropsychiatric manifestations of scrub typhus" 3410: 3083:"Immunization with an autotransporter protein of 2229: 1917:Transactions of the Japanese Society of Pathology 1700:"On the nymph and prosopon of the tsutsugamushi, 228:. Owing to its unique properties, it was renamed 7012: 6772: 5080:Frontiers in Cellular and Infection Microbiology 2930:and related organisms): then, now, and tomorrow" 2346:"Evidence for a peptidoglycan-like structure in 2024:International Journal of Systematic Bacteriology 4819:-based polymerase chain reaction and IgM ELISA" 3378:Japanese Journal of Medical Science and Biology 3135: 2650:Proceedings of the National Academy of Sciences 2395: 2393: 1933: 1910: 1655: 835:. The process of cellular invasion is shown in 5069: 4943: 4919:Journal of the Medical Association of Thailand 3080: 1748: 1564: 976:in bacteria. DNA analyses have shown that the 860:-mediated signaling and reorganisation of the 706: 537:, the bacterium is naturally resistant to all 5312: 4609:Hulmani, M.; Alekya, P.; Kumar, V.J. (2017). 4227: 4051: 4049: 2751: 1864: 1679:, Brumpt), carrier of Japanese river fever". 4478:International Journal of Infectious Diseases 3721:"The 56-kilodalton major protein antigen of 2638: 2399: 2390: 2230:Silverman, D.J.; Wisseman, C.L. Jr. (1978). 2118:"Characterization and growth of polymorphic 1754: 5247: 5065: 5063: 4823:Journal of Clinical and Diagnostic Research 3188: 2176: 2069:sp. nov.) from a patient infected in Dubai" 2001: 1999: 1951: 1949: 1472: 1470: 1468: 1466: 1420: 5319: 5305: 4992: 4105:Journal of Neurosciences in Rural Practice 4046: 3886: 3884: 3882: 3241: 3032: 1708:Brumpt), carrier of tsutsugamushi disease" 1658:Kitasato Archives of Experimental Medicine 1426: 1371: 1317:). The version of record as reviewed is: 946:has four major surface-membrane proteins ( 31: 5277: 5154: 5101: 5091: 4969: 4893: 4883: 4842: 4781: 4740: 4636: 4626: 4585: 4489: 4448: 4407: 4397: 4356: 4346: 4304: 4255: 4245: 4181: 4171: 4126: 4116: 4029: 4019: 3997: 3995: 3993: 3973: 3963: 3918: 3908: 3862: 3801: 3748: 3695: 3642: 3541: 3515: 3513: 3493: 3440: 3218: 3165: 3112: 3102: 3054: 3009: 2999: 2955: 2945: 2919: 2917: 2897: 2848: 2838: 2793: 2783: 2734: 2724: 2679: 2669: 2612: 2559: 2506: 2461: 2417: 2373: 2320: 2267: 2206: 2153: 2092: 2035: 1888:[Aetiology of the tsutsugamushi disease: 1772: 1731: 1675:Hirst, S. (1915). "On the Tsutsugamushi ( 1649: 1632: 1494: 1403: 1393: 1336: 681:Integrative and Conjugative Element (ICE) 481:, which it shares (as of 2010) only with 303:. There is no vaccine for the infection. 5060: 4234:Tropical Medicine and Infectious Disease 3331: 3280: 2934:Tropical Medicine and Infectious Disease 2634: 2632: 2284: 1996: 1946: 1599: 1463: 1102: 807: 710: 598:in blue. The innermost line graph shows 577: 448: 195:and is responsible for a disease called 4272: 4221: 4098: 4092: 3897:World Journal of Critical Care Medicine 3879: 3076: 3074: 2977: 2975: 2696: 1787: 1367: 1365: 7013: 4659: 4143: 3990: 3510: 3035:"Subversion of host cell signaling by 2914: 2532:"Genome sequencing of four strains of 2431: 2429: 2126:Applied and Environmental Microbiology 2058: 1960:and the other groups of Rickettsiae". 1697: 1429:Current Opinion in Infectious Diseases 938: 889:intracellular trafficking or transport 642:by only 9%. Even though adaptation to 335:meaning fever or harm or illness, and 6853: 6852: 6485:Aggregatibacter actinomycetemcomitans 5300: 2629: 1883: 1674: 156:(Hayashi, 1920) (Ogata, 1929) Tamura 5870:Neisseria meningitidis/meningococcus 5070:Valbuena, G.; Walker, D. H. (2013). 3827:"Molecular phylogenetic analysis of 3619:from humans with scrub typhus, Laos" 3071: 2972: 1867:Münchener medizinische Wochenschrift 1614: 1362: 803: 699:is not known. It may be involved in 349:Edinburgh Medical Missionary Society 271:occur annually. Antibiotics such as 4204: 2426: 1790:"Etiology of tsutsugamushi disease" 1065:multiple organ dysfunction syndrome 1029:acute respiratory distress syndrome 924:United States Public Health Service 13: 5332:Gram-negative bacterial infections 5258:Emerging Microbes & Infections 5215:The Journal of Infectious Diseases 5046:10.1093/oxfordjournals.aje.a119366 4872:Indian Journal of Medical Research 4674:10.1111/j.1346-8138.1989.tb01244.x 4228:Jiang, J.; Richards, A.L. (2018). 3843:Vector Borne and Zoonotic Diseases 3543:10.1111/j.1348-0421.1996.tb01120.x 2508:10.1111/j.1574-6968.1995.tb07372.x 1536:10.1111/j.1348-0421.1986.tb02988.x 1010:), which leads to formation of an 594:in green, repeat genes in red and 199:in humans. It is a natural and an 14: 7062: 7031:Externally peer reviewed articles 5689:Human monocytotropic ehrlichiosis 3592:10.1016/j.actatropica.2007.07.013 644:obligate intracellular parasitism 504:. The bacterium is enclosed by a 279:are the main prescription drugs; 206:of mites belonging to the family 5905:Neisseria gonorrhoeae/gonococcus 5880:Waterhouse–Friderichsen syndrome 5072:"Approaches to vaccines against 4437:Journal of Postgraduate Medicine 4386:PLOS Neglected Tropical Diseases 4160:PLOS Neglected Tropical Diseases 4008:PLOS Neglected Tropical Diseases 3952:PLOS Neglected Tropical Diseases 3486:10.1128/JCM.32.11.2780-2785.1994 3474:Journal of Clinical Microbiology 3091:PLOS Neglected Tropical Diseases 2988:PLOS Neglected Tropical Diseases 2827:PLOS Neglected Tropical Diseases 2713:PLOS Neglected Tropical Diseases 2177:Moree, M.F.; Hanson, B. (1992). 2073:Journal of Clinical Microbiology 1962:European Journal of Epidemiology 1712:Journal of Experimental Medicine 1702:Leptotrombidium akamushi, N. Sp. 1441:10.1097/00001432-200310000-00009 1290: 1274:There is no lasting immunity to 757:is an endemic carrier in Japan, 731:In rodent and human infections, 498:transmission electron microscopy 243:, as its cell wall is devoid of 239:, it is not easily stained with 5671:Human granulocytic anaplasmosis 5241: 5198: 5171: 5118: 5021: 4986: 4937: 4910: 4859: 4806: 4757: 4696: 4653: 4602: 4553: 4506: 4465: 4424: 4373: 4321: 4198: 3935: 3818: 3794:10.1128/IAI.58.5.1360-1368.1990 3765: 3741:10.1128/IAI.58.7.2076-2084.1990 3712: 3659: 3606: 3566: 3457: 3404: 3368: 3325: 3274: 3235: 3182: 3129: 3026: 2886:Indian Journal of Public Health 2865: 2810: 2576: 2523: 2478: 2337: 2313:10.1128/IAI.55.9.2290-2292.1987 2260:10.1128/IAI.21.3.1020-1023.1978 2223: 2199:10.1128/IAI.60.8.3405-3415.1992 2170: 2109: 2052: 1927: 1904: 1877: 1858: 1839: 1820: 1781: 1691: 1489:. 48 Suppl (Suppl): S203–S230. 1372:Salje, J.; Kline, K.A. (2017). 1098: 703:between the different strains. 5703:Ehrlichiosis ewingii infection 1668: 1608: 1593: 1567:Reviews of Infectious Diseases 1558: 1511: 1295:This article was submitted to 812:Mechanism of cell invasion by 1: 5519:Flinders Island spotted fever 5007:10.1016/S0140-6736(47)91989-2 4835:10.7860/JCDR/2017/26523.10519 4615:Indian Journal of Dermatology 3688:10.1128/IAI.48.3.671-675.1985 3260:10.1016/j.micpath.2013.06.002 3033:Ge, Y.; Rikihisa, Y. (2011). 1285: 1197: 1035:, gastrointestinal bleeding, 968:species. GroES and GroEL are 737:is the most common vector of 6689:Stenotrophomonas maltophilia 6013:Burkholderia cepacia complex 5449:Rocky Mountain spotted fever 5180:A.M.A. Archives of Pathology 4721:Clinical Infectious Diseases 4566:Emerging Infectious Diseases 4399:10.1371/journal.pntd.0006477 4173:10.1371/journal.pntd.0006346 4021:10.1371/journal.pntd.0005838 3965:10.1371/journal.pntd.0003971 3623:Emerging Infectious Diseases 3104:10.1371/journal.pntd.0003585 3056:10.1016/j.micinf.2011.03.003 3001:10.1371/journal.pntd.0006062 2840:10.1371/journal.pntd.0006632 2785:10.1371/journal.pone.0066595 2726:10.1371/journal.pntd.0006566 1487:Clinical Infectious Diseases 1395:10.1371/journal.ppat.1006657 1217: 1192:Rocky Mountain spotted fever 1132: 984:genes are indeed present in 7: 6350:Far East scarlet-like fever 6344:Yersinia pseudotuberculosis 5960:Chromobacteriosis infection 5034:American Journal of Hygiene 4962:10.1097/MD.0000000000007992 4770:Microbiology and Immunology 3530:Microbiology and Immunology 3417:in southwest area of Korea" 3138:"Intracellular invasion by 2926:"A review of scrub typhus ( 2438:"Diagnosis of scrub typhus" 1794:The Journal of Parasitology 1681:Journal of Economic Biology 1524:Microbiology and Immunology 1269: 972:belonging to the family of 707:Life cycle and transmission 679:), and a greatly amplified 10: 7067: 7046:Bacteria described in 1995 4662:The Journal of Dermatology 4491:10.1016/j.ijid.2013.05.017 4247:10.3390/tropicalmed3010011 3433:10.4269/ajtmh.2011.09-0601 2947:10.3390/tropicalmed3010008 2487:"Phylogenetic position of 2454:10.4269/ajtmh.2010.09-0233 1256: 1188:other rickettsial diseases 1137: 995: 991: 914: 650:depending on the strains ( 444: 306: 6861: 6763: 6725: 6698: 6678: 6634: 6579: 6552: 6507: 6481: 6445: 6377: 6368: 6260: 6225: 6216: 6173: 6150:Hemolytic-uremic syndrome 6068: 6053: 6044: 5985:Burkholderia pseudomallei 5974: 5954:Chromobacterium violaceum 5921: 5894: 5884:Meningococcal septicaemia 5859: 5850: 5841: 5753: 5726: 5717: 5665:Anaplasma phagocytophilum 5650: 5615: 5574: 5432: 5421: 5372: 5356: 5347: 5338: 5254:in scrub typhus patients" 4531:10.1007/s15010-018-1120-x 4348:10.1186/s12879-017-2764-3 2495:FEMS Microbiology Letters 2400:Lalchhandama, K. (2017). 2037:10.1099/00207713-45-3-589 1755:Lalchhandama, K. (2018). 1621:Edinburgh Medical Journal 1113:World Health Organization 483:Candidatus Orientia chuto 301:polymerase chain reaction 297:immunofluorescence assays 218:therapy is not started. 146: 139: 48:Scientific classification 46: 39: 30: 23: 6625:Plesiomonas shigelloides 6407:Brazilian purpuric fever 6024:Bordetella parapertussis 5813:Bartonella bacilliformis 5632:Flea-borne spotted fever 5562:Rickettsia aeschlimannii 5555:Rickettsia aeschlimannii 5547:American tick bite fever 5227:10.1093/infdis/152.4.739 5211:Rickettsia tsutsugamushi 5093:10.3389/fcimb.2012.00170 5030:Rickettsia tsutsugamushi 4885:10.4103/0971-5916.159279 4628:10.4103/0019-5154.198030 4450:10.4103/0022-3859.118033 3776:Rickettsia tsutsugamushi 3723:Rickettsia tsutsugamushi 3670:Rickettsia tsutsugamushi 3468:Rickettsia tsutsugamushi 3390:10.7883/yoken1952.11.383 3195:from cellular autophagy" 2880:Leptotrombidium deliense 2552:10.1128/genomeA.00399-13 2489:Rickettsia tsutsugamushi 2419:10.33493/scivis.17.04.09 2295:Rickettsia tsutsugamushi 2242:Rickettsia tsutsugamushi 2181:Rickettsia tsutsugamushi 2010:Rickettsia tsutsugamushi 1958:Rickettsia tsutsugamushi 1890:Rickettsia tsutsugamushi 1886:Rickettsia tsutsugamushi 1774:10.33493/scivis.18.02.01 1677:Microtrombidium akamushi 1520:Rickettsia tsutsugamushi 1031:, acute kidney failure, 928:complement fixation test 734:Leptotrombidium deliense 701:horizontal gene transfer 412:Rickettsia tsutsugamushi 371:Leptotrombidium akamushi 367:Microtrombidium akamushi 356:It is known here as the 191:belonging to the family 6793:Guillain–Barré syndrome 6709:Cardiobacterium hominis 6669:Acinetobacter baumannii 6611:Vibrio parahaemolyticus 6330:Yersinia enterocolitica 6097:Klebsiella granulomatis 5533:African tick bite fever 5491:North Asian tick typhus 4783:10.1111/1348-0421.12268 4335:BMC Infectious Diseases 4118:10.4103/jnrp.jnrp_44_17 3910:10.5492/wjccm.v4.i3.244 2899:10.4103/0019-557X.85239 2671:10.1073/pnas.0611553104 1579:10.1093/clinids/9.4.823 1325:WikiJournal of Medicine 1297:WikiJournal of Medicine 907:. Further, the escape ( 873:clathrin-coated vesicle 529:, hydroxy fatty acids, 385:Theileria tsutsugamushi 311:The earliest record of 226:Theileria tsutsugamushi 183:meaning "insect") is a 179:meaning "illness", and 6972:orientia-tsutsugamushi 6893:Orientia tsutsugamushi 6863:Orientia tsutsugamushi 6645:Pseudomonas aeruginosa 6563:Francisella tularensis 6522:Legionella longbeachae 6518:Legionella pneumophila 6160:Enterobacter aerogenes 5805:Bacillary angiomatosis 5599:Orientia tsutsugamushi 5505:Queensland tick typhus 5477:Japanese spotted fever 5411:Flying squirrel typhus 5252:Orientia tsutsugamushi 5129:Orientia tsutsugamushi 5074:Orientia tsutsugamushi 4578:10.3201/eid1702.100859 4154:Orientia tsutsugamushi 4099:Mahajan, S.K. (2017). 3946:Orientia tsutsugamushi 3829:Orientia tsutsugamushi 3782:Infection and Immunity 3729:Infection and Immunity 3676:Infection and Immunity 3635:10.3201/eid1409.071259 3617:Orientia tsutsugamushi 3524:Orientia tsutsugamushi 3415:Orientia tsutsugamushi 3248:Microbial Pathogenesis 3244:Orientia tsutsugamushi 3199:Infection and Immunity 3193:Orientia tsutsugamushi 3146:Infection and Immunity 3140:Orientia tsutsugamushi 3085:Orientia tsutsugamushi 3043:Microbes and Infection 3037:Orientia tsutsugamushi 2928:Orientia tsutsugamushi 2876:Schoengastiella ligula 2821:Orientia tsutsugamushi 2707:Orientia tsutsugamushi 2644:Orientia tsutsugamushi 2587:Orientia tsutsugamushi 2354:Molecular Microbiology 2348:Orientia tsutsugamushi 2301:Infection and Immunity 2248:Infection and Immunity 2187:Infection and Immunity 2061:"Isolation of a novel 2018:Orientia tsutsugamushi 1481:Orientia tsutsugamushi 1376:Orientia tsutsugamushi 1223:Orientia tsutsugamushi 1122: 1108: 1089:Guillan-Barré syndrome 1003:Orientia tsutsugamushi 944:Orientia tsutsugamushi 920:Orientia tsutsugamushi 905:herpes simplex viruses 868:Orientia tsutsugamushi 823:initially attacks the 821:Orientia tsutsugamushi 817: 775:Schoengastiella ligula 720:Orientia tsutsugamushi 716: 603: 461:Orientia tsutsugamushi 457: 456:in human (U937) cells. 435:Orientia tsutsugamushi 405:Henrique da Rocha Lima 401:Howard Taylor Ricketts 362: 255:Orientia tsutsugamushi 232:in 1995. Unlike other 230:Orientia tsutsugamushi 222:Orientia tsutsugamushi 212:repeated DNA sequences 204:intracellular parasite 169:Orientia tsutsugamushi 150:Orientia tsutsugamushi 41:Orientia tsutsugamushi 25:Orientia tsutsugamushi 6662:Moraxella catarrhalis 6528:Legionnaires' disease 6449:Pasteurella multocida 6079:Klebsiella pneumoniae 5876:Meningococcal disease 5683:Ehrlichia chaffeensis 5443:Rickettsia rickettsii 5407:Brill–Zinsser disease 5397:Rickettsia prowazekii 5147:10.4269/ajtmh.15-0771 4707:Rickettsia rickettsii 4297:10.4269/ajtmh.13-0064 4070:10.1093/trstmh/trx017 3855:10.1089/vbz.2012.1155 3334:Public Health Reports 3283:Public Health Reports 2605:10.1093/dnares/dsn011 2534:Rickettsia prowazekii 2238:Rickettsia rickettsii 2234:Rickettsia prowazekii 1600:Kawamura, R. (1926). 1338:10.15347/WJM/2019.004 1176:the incubation period 1117: 1115:in 1999 stated that: 1106: 1093:Japanese encephalitis 1073:cranial nerve palsies 996:Further information: 811: 714: 673:transposable elements 657:Rickettsia prowazekii 581: 541:antibiotics (such as 452: 393:Rickettsia orientalis 353: 293:immunochromatographic 133:O. tsutsugamushi 6823:Helicobacter cinaedi 6783:Campylobacter jejuni 6736:Aeromonas hydrophila 6618:Vibrio alginolyticus 6269:Shigella dysenteriae 6207:Citrobacter freundii 6164:Enterobacter cloacae 6020:Bordetella pertussis 5499:Rickettsia australis 5270:10.1038/emi.2017.106 4211:WHO/CDS/CSR/ISR/99.2 3211:10.1128/IAI.00861-12 3158:10.1128/IAI.01316-09 2540:Genome Announcements 2146:10.1128/AEM.00025-08 2122:in a tick cell Line" 2085:10.1128/JCM.01526-10 1788:Hayashi, N. (1920). 1724:10.1084/jem.25.2.255 1301:academic peer review 1142:The main symptom of 1061:subacute thyroiditis 974:molecular chaperones 895:is unusual in using 669:repetitive sequences 16:Species of bacterium 6801:Helicobacter pylori 6291:Bacillary dysentery 6236:Salmonella enterica 6184:Serratia marcescens 6103:Granuloma inguinale 5999:Burkholderia mallei 5934:Eikenella corrodens 5782:Bartonella quintana 5774:Cat-scratch disease 5768:Bartonella henselae 5485:Rickettsia sibirica 5471:Rickettsia japonica 5207:Macaca fascicularis 2776:2013PLoSO...866595V 2662:2007PNAS..104.7981C 2138:2008ApEnM..74.3151S 2008:"Classification of 1706:Trombidium akamushi 1698:Nagayo, M. (1917). 1615:Palm, T.A. (1878). 1085:transverse myelitis 1077:meningoencephalitis 970:heat shock proteins 939:Antigenic variation 932:antigenic variation 416:Rickettsia akamushi 83:Alphaproteobacteria 6789:Campylobacteriosis 6700:Cardiobacteriaceae 6201:Citrobacter koseri 6111:Klebsiella oxytoca 5541:Rickettsia parkeri 5527:Rickettsia africae 5457:Rickettsia conorii 4733:10.1093/cid/ciu358 4711:Rickettsia parkeri 4515:Rickettsia parkeri 4217:on April 18, 2003. 3191:"Active escape of 2819:"Heterogeneity of 2059:Izzard, L (2010). 1974:10.1007/BF00145675 1184:dorsum of the feet 1109: 964:, but not that of 818: 796:is present in the 717: 604: 588:repetitive regions 458: 341:Niigata Prefecture 7008: 7007: 6993:Open Tree of Life 6855:Taxon identifiers 6846: 6845: 6842: 6841: 6774:Campylobacterales 6759: 6758: 6740:Aeromonas veronii 6604:Vibrio vulnificus 6536:Coxiella burnetii 6503: 6502: 6429:H. parainfluenzae 6364: 6363: 6360: 6359: 6299:Proteus mirabilis 6246:Paratyphoid fever 6135:Enterohemorrhagic 6055:Enterobacteriales 6040: 6039: 5970: 5969: 5837: 5836: 5833: 5832: 5819:Carrion's disease 5713: 5712: 5697:Ehrlichia ewingii 5646: 5645: 5642: 5641: 5463:Boutonneuse fever 5001:(6450): 481–483. 3480:(11): 2780–2785. 3466:"Transmission of 3289:(50): 1483–1488. 2656:(19): 7981–7986. 2366:10.1111/mmi.13709 2132:(10): 3151–3158. 2079:(12): 4404–4409. 958:of the bacterium 829:endothelial cells 804:Cellular invasion 759:L. chiangraiensis 630:. In contrast to 608:biosafety level 3 492:The structure of 245:lipophosphoglycan 165: 164: 7058: 7001: 7000: 6988: 6987: 6975: 6974: 6962: 6961: 6949: 6948: 6936: 6935: 6923: 6922: 6910: 6909: 6897: 6896: 6895: 6882: 6881: 6880: 6850: 6849: 6770: 6769: 6680:Xanthomonadaceae 6488: 6471:Actinobacillosis 6452: 6385: 6375: 6374: 6305:Proteus vulgaris 6223: 6222: 6120:Escherichia coli 6066: 6065: 6051: 6050: 5926: 5857: 5856: 5848: 5847: 5737:Brucella abortus 5724: 5723: 5719:Hyphomicrobiales 5626:Rickettsia felis 5585:Rickettsia akari 5513:Rickettsia honei 5430: 5429: 5383:Rickettsia typhi 5370: 5369: 5354: 5353: 5345: 5344: 5321: 5314: 5307: 5298: 5297: 5292: 5291: 5281: 5245: 5239: 5238: 5202: 5196: 5195: 5175: 5169: 5168: 5158: 5122: 5116: 5115: 5105: 5095: 5067: 5058: 5057: 5025: 5019: 5018: 4990: 4984: 4983: 4973: 4941: 4935: 4934: 4914: 4908: 4907: 4897: 4887: 4863: 4857: 4856: 4846: 4829:(8): DC27–DC31. 4810: 4804: 4803: 4785: 4761: 4755: 4754: 4744: 4715:Rickettsia akari 4700: 4694: 4693: 4657: 4651: 4650: 4640: 4630: 4606: 4600: 4599: 4589: 4557: 4551: 4550: 4510: 4504: 4503: 4493: 4484:(11): e981-987. 4469: 4463: 4462: 4452: 4428: 4422: 4421: 4411: 4401: 4377: 4371: 4370: 4360: 4350: 4325: 4319: 4318: 4308: 4276: 4270: 4269: 4259: 4249: 4225: 4219: 4218: 4202: 4196: 4195: 4185: 4175: 4147: 4141: 4140: 4130: 4120: 4096: 4090: 4089: 4053: 4044: 4043: 4033: 4023: 3999: 3988: 3987: 3977: 3967: 3939: 3933: 3932: 3922: 3912: 3888: 3877: 3876: 3866: 3822: 3816: 3815: 3805: 3788:(5): 1360–1368. 3769: 3763: 3762: 3752: 3735:(7): 2076–2084. 3716: 3710: 3709: 3699: 3663: 3657: 3656: 3646: 3629:(9): 1483–1485. 3610: 3604: 3603: 3576:O. tsutsugamushi 3570: 3564: 3563: 3545: 3517: 3508: 3507: 3497: 3461: 3455: 3454: 3444: 3408: 3402: 3401: 3372: 3366: 3365: 3329: 3323: 3322: 3278: 3272: 3271: 3239: 3233: 3232: 3222: 3186: 3180: 3179: 3169: 3152:(5): 1915–1923. 3133: 3127: 3126: 3116: 3106: 3078: 3069: 3068: 3058: 3030: 3024: 3023: 3013: 3003: 2994:(11): e0006062. 2979: 2970: 2969: 2959: 2949: 2921: 2912: 2911: 2901: 2869: 2863: 2862: 2852: 2842: 2814: 2808: 2807: 2797: 2787: 2755: 2749: 2748: 2738: 2728: 2700: 2694: 2693: 2683: 2673: 2636: 2627: 2626: 2616: 2580: 2574: 2573: 2563: 2546:(3): e00399-13. 2527: 2521: 2520: 2510: 2501:(2–3): 299–304. 2482: 2476: 2475: 2465: 2433: 2424: 2423: 2421: 2397: 2388: 2387: 2377: 2341: 2335: 2334: 2324: 2307:(9): 2290–2292. 2288: 2282: 2281: 2271: 2254:(3): 1020–1023. 2227: 2221: 2220: 2210: 2193:(8): 3405–3415. 2174: 2168: 2167: 2157: 2120:Rickettsia felis 2113: 2107: 2106: 2096: 2056: 2050: 2049: 2039: 2012:in a new genus, 2003: 1994: 1993: 1953: 1944: 1943: 1931: 1925: 1924: 1908: 1902: 1901: 1881: 1875: 1874: 1873:(39): 1381–1384. 1862: 1856: 1855: 1843: 1837: 1836: 1824: 1818: 1817: 1785: 1779: 1778: 1776: 1752: 1746: 1745: 1735: 1695: 1689: 1688: 1672: 1666: 1665: 1653: 1647: 1646: 1636: 1612: 1606: 1605: 1597: 1591: 1590: 1562: 1556: 1555: 1515: 1509: 1508: 1498: 1474: 1461: 1460: 1424: 1418: 1417: 1407: 1397: 1388:(12): e1006657. 1369: 1358: 1340: 1316: 1305:reviewer reports 1294: 1280:O. tsutsugamushi 1276:O. tsutsugamushi 1263:O. tsutsugamushi 1212:O. tsutsugamushi 1204:O. tsutsugamushi 1144:O. tsutsugamushi 986:O. tsutsugamushi 961:Escherichia coli 893:O. tsutsugamushi 814:O. tsutsugamushi 794:O. tsutsugamushi 739:O. tsutsugamushi 697:O. tsutsugamushi 685:O. tsutsugamushi 665:O. tsutsugamushi 636:O. tsutsugamushi 612:O. tsutsugamushi 584:O. tsutsugamushi 494:O. tsutsugamushi 465:O. tsutsugamushi 454:O. tsutsugamushi 439:O. tsutsugamushi 427:R. tsutsugamushi 313:O. tsutsugamushi 152: 35: 21: 20: 7066: 7065: 7061: 7060: 7059: 7057: 7056: 7055: 7011: 7010: 7009: 7004: 6996: 6991: 6983: 6978: 6970: 6965: 6957: 6952: 6944: 6939: 6931: 6926: 6918: 6913: 6905: 6900: 6891: 6890: 6885: 6876: 6875: 6870: 6857: 6847: 6838: 6755: 6721: 6694: 6674: 6636:Pseudomonadales 6630: 6590:Vibrio cholerae 6575: 6548: 6499: 6482: 6477: 6446: 6441: 6378: 6356: 6312:Yersinia pestis 6256: 6212: 6169: 6125:Enterotoxigenic 6057: 6036: 5976:Burkholderiales 5966: 5940:Kingella kingae 5922: 5917: 5890: 5829: 5823:Verruga peruana 5749: 5709: 5652:Anaplasmataceae 5638: 5611: 5570: 5424: 5417: 5403:Epidemic typhus 5361: 5334: 5325: 5295: 5246: 5242: 5203: 5199: 5176: 5172: 5131:strain Boryong" 5123: 5119: 5068: 5061: 5026: 5022: 4991: 4987: 4942: 4938: 4915: 4911: 4864: 4860: 4811: 4807: 4762: 4758: 4701: 4697: 4658: 4654: 4607: 4603: 4558: 4554: 4511: 4507: 4470: 4466: 4429: 4425: 4392:(5): e0006477. 4378: 4374: 4326: 4322: 4277: 4273: 4226: 4222: 4203: 4199: 4166:(3): e0006346. 4148: 4144: 4097: 4093: 4054: 4047: 4014:(9): e0005838. 4000: 3991: 3958:(8): e0003971. 3940: 3936: 3889: 3880: 3849:(11): 825–829. 3823: 3819: 3770: 3766: 3717: 3713: 3664: 3660: 3615:"Genotyping of 3611: 3607: 3571: 3567: 3518: 3511: 3462: 3458: 3409: 3405: 3373: 3369: 3346:10.2307/4585717 3340:(24): 887–894. 3330: 3326: 3295:10.2307/4585496 3279: 3275: 3240: 3236: 3187: 3183: 3134: 3130: 3097:(3): e0003585. 3079: 3072: 3031: 3027: 2980: 2973: 2922: 2915: 2882:been replaced?" 2870: 2866: 2833:(7): e0006632. 2815: 2811: 2756: 2752: 2719:(6): e0006566. 2701: 2697: 2637: 2630: 2581: 2577: 2528: 2524: 2483: 2479: 2434: 2427: 2398: 2391: 2342: 2338: 2289: 2285: 2228: 2224: 2175: 2171: 2114: 2110: 2057: 2053: 2004: 1997: 1954: 1947: 1942:(4/5): 253–261. 1932: 1928: 1909: 1905: 1882: 1878: 1863: 1859: 1844: 1840: 1825: 1821: 1806:10.2307/3270957 1786: 1782: 1753: 1749: 1696: 1692: 1673: 1669: 1654: 1650: 1613: 1609: 1598: 1594: 1563: 1559: 1516: 1512: 1475: 1464: 1425: 1421: 1370: 1363: 1318: 1312: 1288: 1272: 1259: 1251:contraindicated 1231:chloramphenicol 1220: 1208:Weil–Felix test 1200: 1140: 1135: 1101: 1020:lymphadenopathy 1000: 994: 941: 917: 841:dendritic cells 806: 798:salivary glands 725:Leptotrombidium 709: 677:Group II intron 447: 369:(later renamed 309: 289:Weil–Felix test 281:chloramphenicol 161: 154: 148: 135: 123: 109: 97: 85: 73: 61: 17: 12: 11: 5: 7064: 7054: 7053: 7048: 7043: 7041:Rickettsiaceae 7038: 7033: 7028: 7023: 7006: 7005: 7003: 7002: 6989: 6976: 6963: 6950: 6937: 6924: 6911: 6898: 6883: 6867: 6865: 6859: 6858: 6844: 6843: 6840: 6839: 6837: 6836: 6835: 6834: 6819: 6818: 6817: 6815:Gastric cancer 6797: 6796: 6795: 6778: 6776: 6767: 6761: 6760: 6757: 6756: 6754: 6753: 6752: 6751: 6731: 6729: 6723: 6722: 6720: 6719: 6718: 6717: 6704: 6702: 6696: 6695: 6693: 6692: 6684: 6682: 6676: 6675: 6673: 6672: 6665: 6658: 6657: 6656: 6640: 6638: 6632: 6631: 6629: 6628: 6621: 6614: 6607: 6600: 6599: 6598: 6585: 6583: 6577: 6576: 6574: 6573: 6572: 6571: 6558: 6556: 6550: 6549: 6547: 6546: 6545: 6544: 6532: 6531: 6530: 6513: 6511: 6505: 6504: 6501: 6500: 6498: 6497: 6491: 6489: 6479: 6478: 6476: 6475: 6474: 6473: 6465:Actinobacillus 6461: 6459:Pasteurellosis 6455: 6453: 6443: 6442: 6440: 6439: 6438: 6437: 6425: 6424: 6423: 6411: 6410: 6409: 6404: 6388: 6386: 6372: 6370:Pasteurellales 6366: 6365: 6362: 6361: 6358: 6357: 6355: 6354: 6353: 6352: 6340: 6339: 6338: 6326: 6325: 6324: 6322:Bubonic plague 6308: 6295: 6294: 6293: 6264: 6262: 6258: 6257: 6255: 6254: 6253: 6252: 6231: 6229: 6220: 6214: 6213: 6211: 6210: 6197: 6196: 6195: 6179: 6177: 6171: 6170: 6168: 6167: 6155: 6154: 6153: 6152: 6142: 6137: 6132: 6130:Enteroinvasive 6127: 6115: 6114: 6107: 6106: 6105: 6093: 6092: 6091: 6074: 6072: 6063: 6048: 6042: 6041: 6038: 6037: 6035: 6034: 6033: 6032: 6016: 6009: 6008: 6007: 5995: 5994: 5993: 5980: 5978: 5972: 5971: 5968: 5967: 5965: 5964: 5963: 5962: 5950: 5949: 5948: 5929: 5927: 5919: 5918: 5916: 5915: 5914: 5913: 5900: 5898: 5892: 5891: 5889: 5888: 5887: 5886: 5865: 5863: 5854: 5845: 5839: 5838: 5835: 5834: 5831: 5830: 5828: 5827: 5826: 5825: 5809: 5808: 5807: 5792: 5791: 5790: 5778: 5777: 5776: 5759: 5757: 5755:Bartonellaceae 5751: 5750: 5748: 5747: 5746: 5745: 5732: 5730: 5721: 5715: 5714: 5711: 5710: 5708: 5707: 5706: 5705: 5693: 5692: 5691: 5679: 5678: 5677: 5656: 5654: 5648: 5647: 5644: 5643: 5640: 5639: 5637: 5636: 5635: 5634: 5621: 5619: 5613: 5612: 5610: 5609: 5608: 5607: 5595: 5594: 5593: 5591:Rickettsialpox 5580: 5578: 5572: 5571: 5569: 5568: 5567: 5566: 5551: 5550: 5549: 5537: 5536: 5535: 5523: 5522: 5521: 5509: 5508: 5507: 5495: 5494: 5493: 5481: 5480: 5479: 5467: 5466: 5465: 5453: 5452: 5451: 5438: 5436: 5427: 5419: 5418: 5416: 5415: 5414: 5413: 5393: 5392: 5391: 5378: 5376: 5367: 5358:Rickettsiaceae 5351: 5342: 5336: 5335: 5328:Pseudomonadota 5324: 5323: 5316: 5309: 5301: 5294: 5293: 5240: 5221:(4): 739–749. 5197: 5186:(6): 847–861. 5170: 5117: 5059: 5040:(3): 337–342. 5020: 4985: 4936: 4925:(8): 756–760. 4909: 4858: 4805: 4776:(7): 371–374. 4756: 4727:(5): 635–642. 4705:"Detection of 4695: 4668:(3): 169–177. 4652: 4601: 4572:(2): 275–278. 4552: 4525:(4): 559–563. 4505: 4464: 4443:(3): 177–178. 4423: 4372: 4320: 4291:(2): 301–307. 4271: 4220: 4197: 4152:"Emergence of 4142: 4111:(3): 421–426. 4091: 4045: 3989: 3934: 3903:(3): 244–250. 3878: 3817: 3764: 3711: 3682:(3): 671–675. 3658: 3605: 3565: 3536:(9): 627–638. 3509: 3456: 3427:(2): 250–254. 3403: 3384:(5): 383–399. 3367: 3324: 3273: 3234: 3205:(2): 552–559. 3181: 3128: 3070: 3049:(7): 638–648. 3025: 2971: 2913: 2874:"Emergence of 2864: 2809: 2750: 2695: 2628: 2599:(4): 185–199. 2575: 2522: 2477: 2448:(3): 368–370. 2425: 2412:(4): 250–259. 2406:Science Vision 2389: 2360:(3): 440–452. 2336: 2283: 2222: 2169: 2108: 2051: 2030:(3): 589–591. 2016:gen. nov., as 1995: 1968:(3): 259–269. 1945: 1926: 1903: 1876: 1857: 1838: 1819: 1780: 1761:Science Vision 1747: 1718:(2): 255–272. 1690: 1667: 1648: 1627:(2): 128–132. 1607: 1592: 1573:(4): 823–840. 1557: 1530:(7): 611–620. 1510: 1496:10.1086/596576 1462: 1435:(5): 429–436. 1419: 1382:PLOS Pathogens 1360: 1287: 1284: 1271: 1268: 1258: 1255: 1219: 1216: 1199: 1196: 1139: 1136: 1134: 1131: 1100: 1097: 993: 990: 940: 937: 916: 913: 864:cytoskeleton. 805: 802: 769:in China, and 708: 705: 693:ankyrin repeat 514:Gimenez stains 500:) is shown in 487:binary fission 446: 443: 323:(red mite) or 308: 305: 262:, are natural 193:Rickettsiaceae 163: 162: 155: 144: 143: 137: 136: 131: 129: 125: 124: 117: 115: 111: 110: 107:Rickettsiaceae 105: 103: 99: 98: 93: 91: 87: 86: 81: 79: 75: 74: 71:Pseudomonadota 69: 67: 63: 62: 57: 55: 51: 50: 44: 43: 37: 36: 28: 27: 15: 9: 6: 4: 3: 2: 7063: 7052: 7051:Rickettsioses 7049: 7047: 7044: 7042: 7039: 7037: 7034: 7032: 7029: 7027: 7024: 7022: 7019: 7018: 7016: 6999: 6994: 6990: 6986: 6981: 6977: 6973: 6968: 6964: 6960: 6955: 6951: 6947: 6942: 6938: 6934: 6929: 6925: 6921: 6916: 6912: 6908: 6903: 6899: 6894: 6888: 6884: 6879: 6873: 6869: 6868: 6866: 6864: 6860: 6856: 6851: 6833: 6831: 6827: 6826: 6825: 6824: 6820: 6816: 6812: 6811:MALT lymphoma 6808: 6805: 6804: 6803: 6802: 6798: 6794: 6790: 6787: 6786: 6785: 6784: 6780: 6779: 6777: 6775: 6771: 6768: 6766: 6762: 6750: 6748: 6744: 6743: 6742: 6741: 6737: 6733: 6732: 6730: 6728: 6727:Aeromonadales 6724: 6716: 6713: 6712: 6711: 6710: 6706: 6705: 6703: 6701: 6697: 6691: 6690: 6686: 6685: 6683: 6681: 6677: 6671: 6670: 6666: 6664: 6663: 6659: 6655: 6653: 6649: 6648: 6647: 6646: 6642: 6641: 6639: 6637: 6633: 6627: 6626: 6622: 6620: 6619: 6615: 6613: 6612: 6608: 6606: 6605: 6601: 6597: 6594: 6593: 6592: 6591: 6587: 6586: 6584: 6582: 6578: 6570: 6567: 6566: 6565: 6564: 6560: 6559: 6557: 6555: 6554:Thiotrichales 6551: 6543: 6540: 6539: 6538: 6537: 6533: 6529: 6526: 6525: 6524: 6523: 6519: 6515: 6514: 6512: 6510: 6509:Legionellales 6506: 6496: 6493: 6492: 6490: 6487: 6486: 6480: 6472: 6469: 6468: 6467: 6466: 6462: 6460: 6457: 6456: 6454: 6451: 6450: 6444: 6436: 6433: 6432: 6431: 6430: 6426: 6422: 6419: 6418: 6417: 6416: 6412: 6408: 6405: 6403: 6401: 6397: 6396: 6395: 6394: 6393:H. influenzae 6390: 6389: 6387: 6384: 6382: 6376: 6373: 6371: 6367: 6351: 6348: 6347: 6346: 6345: 6341: 6337: 6334: 6333: 6332: 6331: 6327: 6323: 6319: 6316: 6315: 6314: 6313: 6309: 6307: 6306: 6301: 6300: 6296: 6292: 6288: 6285: 6284: 6283: 6282: 6278: 6274: 6270: 6266: 6265: 6263: 6259: 6251: 6250:Salmonellosis 6247: 6243: 6242:Typhoid fever 6240: 6239: 6238: 6237: 6233: 6232: 6230: 6228: 6224: 6221: 6219: 6215: 6209: 6208: 6203: 6202: 6198: 6194: 6192: 6188: 6187: 6186: 6185: 6181: 6180: 6178: 6176: 6172: 6166: 6165: 6161: 6157: 6156: 6151: 6148: 6147: 6146: 6143: 6141: 6138: 6136: 6133: 6131: 6128: 6126: 6122: 6121: 6117: 6116: 6113: 6112: 6108: 6104: 6101: 6100: 6099: 6098: 6094: 6090: 6086: 6085:Rhinoscleroma 6083: 6082: 6081: 6080: 6076: 6075: 6073: 6071: 6067: 6064: 6061: 6056: 6052: 6049: 6047: 6043: 6031: 6028: 6027: 6026: 6025: 6021: 6017: 6015: 6014: 6010: 6006: 6003: 6002: 6001: 6000: 5996: 5992: 5989: 5988: 5987: 5986: 5982: 5981: 5979: 5977: 5973: 5961: 5958: 5957: 5956: 5955: 5951: 5947: 5944: 5943: 5942: 5941: 5936: 5935: 5931: 5930: 5928: 5925: 5920: 5912: 5909: 5908: 5907: 5906: 5902: 5901: 5899: 5897: 5893: 5885: 5881: 5877: 5874: 5873: 5872: 5871: 5867: 5866: 5864: 5862: 5858: 5855: 5853: 5849: 5846: 5844: 5840: 5824: 5820: 5817: 5816: 5815: 5814: 5810: 5806: 5803: 5802: 5801: 5797: 5793: 5789: 5786: 5785: 5784: 5783: 5779: 5775: 5772: 5771: 5770: 5769: 5764: 5763:Bartonellosis 5761: 5760: 5758: 5756: 5752: 5744: 5741: 5740: 5739: 5738: 5734: 5733: 5731: 5729: 5725: 5722: 5720: 5716: 5704: 5701: 5700: 5699: 5698: 5694: 5690: 5687: 5686: 5685: 5684: 5680: 5676: 5672: 5669: 5668: 5667: 5666: 5661: 5658: 5657: 5655: 5653: 5649: 5633: 5630: 5629: 5628: 5627: 5623: 5622: 5620: 5618: 5614: 5606: 5603: 5602: 5601: 5600: 5596: 5592: 5589: 5588: 5587: 5586: 5582: 5581: 5579: 5577: 5573: 5565: 5563: 5559: 5558: 5557: 5556: 5552: 5548: 5545: 5544: 5543: 5542: 5538: 5534: 5531: 5530: 5529: 5528: 5524: 5520: 5517: 5516: 5515: 5514: 5510: 5506: 5503: 5502: 5501: 5500: 5496: 5492: 5489: 5488: 5487: 5486: 5482: 5478: 5475: 5474: 5473: 5472: 5468: 5464: 5461: 5460: 5459: 5458: 5454: 5450: 5447: 5446: 5445: 5444: 5440: 5439: 5437: 5435: 5431: 5428: 5426: 5420: 5412: 5408: 5404: 5401: 5400: 5399: 5398: 5394: 5390: 5389:Murine typhus 5387: 5386: 5385: 5384: 5380: 5379: 5377: 5375: 5371: 5368: 5365: 5364:Rickettsioses 5359: 5355: 5352: 5350: 5349:Rickettsiales 5346: 5343: 5341: 5337: 5333: 5329: 5322: 5317: 5315: 5310: 5308: 5303: 5302: 5299: 5289: 5285: 5280: 5275: 5271: 5267: 5263: 5259: 5255: 5253: 5244: 5236: 5232: 5228: 5224: 5220: 5216: 5212: 5208: 5201: 5193: 5189: 5185: 5181: 5174: 5166: 5162: 5157: 5152: 5148: 5144: 5140: 5136: 5132: 5130: 5121: 5113: 5109: 5104: 5099: 5094: 5089: 5085: 5081: 5077: 5075: 5066: 5064: 5055: 5051: 5047: 5043: 5039: 5035: 5031: 5024: 5016: 5012: 5008: 5004: 5000: 4996: 4989: 4981: 4977: 4972: 4967: 4963: 4959: 4956:(36): e7992. 4955: 4951: 4947: 4940: 4932: 4928: 4924: 4920: 4913: 4905: 4901: 4896: 4891: 4886: 4881: 4878:(4): 417–22. 4877: 4873: 4869: 4862: 4854: 4850: 4845: 4840: 4836: 4832: 4828: 4824: 4820: 4818: 4809: 4801: 4797: 4793: 4789: 4784: 4779: 4775: 4771: 4767: 4760: 4752: 4748: 4743: 4738: 4734: 4730: 4726: 4722: 4718: 4716: 4712: 4708: 4699: 4691: 4687: 4683: 4679: 4675: 4671: 4667: 4663: 4656: 4648: 4644: 4639: 4634: 4629: 4624: 4620: 4616: 4612: 4605: 4597: 4593: 4588: 4583: 4579: 4575: 4571: 4567: 4563: 4556: 4548: 4544: 4540: 4536: 4532: 4528: 4524: 4520: 4516: 4509: 4501: 4497: 4492: 4487: 4483: 4479: 4475: 4468: 4460: 4456: 4451: 4446: 4442: 4438: 4434: 4427: 4419: 4415: 4410: 4405: 4400: 4395: 4391: 4387: 4383: 4376: 4368: 4364: 4359: 4354: 4349: 4344: 4340: 4336: 4332: 4324: 4316: 4312: 4307: 4302: 4298: 4294: 4290: 4286: 4282: 4275: 4267: 4263: 4258: 4253: 4248: 4243: 4239: 4235: 4231: 4224: 4216: 4212: 4208: 4201: 4193: 4189: 4184: 4179: 4174: 4169: 4165: 4161: 4157: 4155: 4146: 4138: 4134: 4129: 4124: 4119: 4114: 4110: 4106: 4102: 4095: 4087: 4083: 4079: 4075: 4071: 4067: 4063: 4059: 4052: 4050: 4041: 4037: 4032: 4027: 4022: 4017: 4013: 4009: 4005: 3998: 3996: 3994: 3985: 3981: 3976: 3971: 3966: 3961: 3957: 3953: 3949: 3947: 3938: 3930: 3926: 3921: 3916: 3911: 3906: 3902: 3898: 3894: 3887: 3885: 3883: 3874: 3870: 3865: 3860: 3856: 3852: 3848: 3844: 3840: 3838: 3834: 3831:based on the 3830: 3821: 3813: 3809: 3804: 3799: 3795: 3791: 3787: 3783: 3779: 3777: 3768: 3760: 3756: 3751: 3746: 3742: 3738: 3734: 3730: 3726: 3724: 3715: 3707: 3703: 3698: 3693: 3689: 3685: 3681: 3677: 3673: 3671: 3662: 3654: 3650: 3645: 3640: 3636: 3632: 3628: 3624: 3620: 3618: 3609: 3601: 3597: 3593: 3589: 3585: 3581: 3577: 3569: 3561: 3557: 3553: 3549: 3544: 3539: 3535: 3531: 3527: 3525: 3516: 3514: 3505: 3501: 3496: 3491: 3487: 3483: 3479: 3475: 3471: 3469: 3460: 3452: 3448: 3443: 3438: 3434: 3430: 3426: 3422: 3418: 3416: 3407: 3399: 3395: 3391: 3387: 3383: 3379: 3371: 3363: 3359: 3355: 3351: 3347: 3343: 3339: 3335: 3328: 3320: 3316: 3312: 3308: 3304: 3300: 3296: 3292: 3288: 3284: 3277: 3269: 3265: 3261: 3257: 3253: 3249: 3245: 3238: 3230: 3226: 3221: 3216: 3212: 3208: 3204: 3200: 3196: 3194: 3185: 3177: 3173: 3168: 3163: 3159: 3155: 3151: 3147: 3143: 3141: 3132: 3124: 3120: 3115: 3110: 3105: 3100: 3096: 3092: 3088: 3086: 3077: 3075: 3066: 3062: 3057: 3052: 3048: 3044: 3040: 3038: 3029: 3021: 3017: 3012: 3007: 3002: 2997: 2993: 2989: 2985: 2978: 2976: 2967: 2963: 2958: 2953: 2948: 2943: 2939: 2935: 2931: 2929: 2920: 2918: 2909: 2905: 2900: 2895: 2891: 2887: 2883: 2881: 2877: 2868: 2860: 2856: 2851: 2846: 2841: 2836: 2832: 2828: 2824: 2822: 2813: 2805: 2801: 2796: 2791: 2786: 2781: 2777: 2773: 2770:(6): e66595. 2769: 2765: 2761: 2754: 2746: 2742: 2737: 2732: 2727: 2722: 2718: 2714: 2710: 2708: 2699: 2691: 2687: 2682: 2677: 2672: 2667: 2663: 2659: 2655: 2651: 2647: 2645: 2635: 2633: 2624: 2620: 2615: 2610: 2606: 2602: 2598: 2594: 2590: 2588: 2579: 2571: 2567: 2562: 2557: 2553: 2549: 2545: 2541: 2537: 2535: 2526: 2518: 2514: 2509: 2504: 2500: 2496: 2492: 2490: 2481: 2473: 2469: 2464: 2459: 2455: 2451: 2447: 2443: 2439: 2432: 2430: 2420: 2415: 2411: 2407: 2403: 2396: 2394: 2385: 2381: 2376: 2371: 2367: 2363: 2359: 2355: 2351: 2349: 2340: 2332: 2328: 2323: 2318: 2314: 2310: 2306: 2302: 2298: 2296: 2287: 2279: 2275: 2270: 2265: 2261: 2257: 2253: 2249: 2245: 2243: 2239: 2235: 2226: 2218: 2214: 2209: 2204: 2200: 2196: 2192: 2188: 2184: 2182: 2173: 2165: 2161: 2156: 2151: 2147: 2143: 2139: 2135: 2131: 2127: 2123: 2121: 2112: 2104: 2100: 2095: 2090: 2086: 2082: 2078: 2074: 2070: 2068: 2064: 2055: 2047: 2043: 2038: 2033: 2029: 2025: 2021: 2019: 2015: 2011: 2002: 2000: 1991: 1987: 1983: 1979: 1975: 1971: 1967: 1963: 1959: 1952: 1950: 1941: 1937: 1930: 1922: 1918: 1914: 1907: 1899: 1895: 1891: 1887: 1880: 1872: 1868: 1861: 1853: 1849: 1842: 1835:(4): 309–318. 1834: 1830: 1823: 1815: 1811: 1807: 1803: 1799: 1795: 1791: 1784: 1775: 1770: 1766: 1762: 1758: 1751: 1743: 1739: 1734: 1729: 1725: 1721: 1717: 1713: 1709: 1707: 1703: 1694: 1686: 1682: 1678: 1671: 1663: 1659: 1652: 1644: 1640: 1635: 1630: 1626: 1622: 1618: 1611: 1603: 1596: 1588: 1584: 1580: 1576: 1572: 1568: 1561: 1553: 1549: 1545: 1541: 1537: 1533: 1529: 1525: 1521: 1514: 1506: 1502: 1497: 1492: 1488: 1484: 1482: 1473: 1471: 1469: 1467: 1458: 1454: 1450: 1446: 1442: 1438: 1434: 1430: 1423: 1415: 1411: 1406: 1401: 1396: 1391: 1387: 1383: 1379: 1377: 1368: 1366: 1361: 1359: 1356: 1352: 1348: 1344: 1339: 1334: 1330: 1326: 1322: 1315: 1310: 1306: 1302: 1299:for external 1298: 1293: 1283: 1281: 1277: 1267: 1264: 1254: 1252: 1248: 1244: 1243:roxithromycin 1240: 1236: 1232: 1228: 1224: 1215: 1213: 1209: 1205: 1195: 1193: 1189: 1185: 1181: 1177: 1173: 1169: 1165: 1161: 1160:murine typhus 1157: 1153: 1152:leptospirosis 1149: 1145: 1130: 1128: 1121: 1116: 1114: 1105: 1096: 1094: 1090: 1086: 1082: 1078: 1074: 1070: 1066: 1062: 1058: 1054: 1050: 1046: 1042: 1038: 1034: 1030: 1025: 1021: 1017: 1013: 1009: 1004: 999: 989: 987: 983: 979: 975: 971: 967: 963: 962: 957: 953: 949: 945: 936: 933: 929: 925: 921: 912: 910: 906: 902: 898: 894: 890: 886: 882: 878: 874: 869: 865: 863: 859: 855: 851: 846: 842: 838: 834: 830: 826: 822: 815: 810: 801: 799: 795: 791: 786: 785: 780: 776: 772: 768: 767:L. gaohuensis 765:in Thailand, 764: 760: 756: 752: 751:L. scutellare 748: 744: 740: 736: 735: 729: 727: 726: 721: 713: 704: 702: 698: 694: 690: 686: 682: 678: 674: 670: 666: 661: 659: 658: 653: 649: 645: 641: 637: 633: 629: 625: 621: 617: 613: 609: 601: 597: 593: 589: 585: 580: 576: 573: 569: 565: 562:are missing: 561: 557: 553: 548: 544: 540: 536: 535:peptidoglycan 532: 528: 524: 519: 515: 511: 507: 503: 499: 496:(revealed by 495: 490: 488: 484: 480: 476: 475: 470: 466: 462: 455: 451: 442: 440: 436: 432: 428: 424: 423:R. orientalis 419: 417: 413: 408: 406: 402: 398: 397:R. prowazekii 394: 390: 389:R. prowazekii 386: 382: 381: 374: 372: 368: 361: 359: 352: 350: 346: 345:Shinano River 342: 338: 334: 330: 329:tsutsugamushi 326: 322: 318: 314: 304: 302: 298: 294: 290: 286: 282: 278: 274: 269: 265: 264:ectoparasites 261: 256: 252: 250: 249:peptidoglycan 246: 242: 238: 235: 234:Gram-negative 231: 227: 223: 219: 217: 213: 209: 208:Trombiculidae 205: 202: 198: 194: 190: 186: 182: 178: 175: 171: 170: 159: 153: 151: 145: 142: 141:Binomial name 138: 134: 130: 127: 126: 122: 121: 116: 113: 112: 108: 104: 101: 100: 96: 95:Rickettsiales 92: 89: 88: 84: 80: 77: 76: 72: 68: 65: 64: 60: 56: 53: 52: 49: 45: 42: 38: 34: 29: 26: 22: 19: 6862: 6830:Helicobacter 6829: 6821: 6807:Peptic ulcer 6799: 6781: 6746: 6734: 6707: 6687: 6667: 6660: 6651: 6643: 6623: 6616: 6609: 6602: 6588: 6581:Vibrionaceae 6561: 6534: 6516: 6483: 6463: 6447: 6427: 6413: 6399: 6391: 6379: 6342: 6328: 6310: 6303: 6297: 6267: 6234: 6205: 6199: 6190: 6182: 6158: 6118: 6109: 6095: 6077: 6018: 6011: 5997: 5983: 5952: 5938: 5932: 5923: 5903: 5868: 5852:Neisseriales 5811: 5799: 5795: 5788:Trench fever 5780: 5766: 5735: 5728:Brucellaceae 5695: 5681: 5675:Anaplasmosis 5663: 5660:Ehrlichiosis 5624: 5605:Scrub typhus 5598: 5597: 5583: 5561: 5553: 5539: 5525: 5511: 5497: 5483: 5469: 5455: 5441: 5395: 5381: 5330:-associated 5264:(12): e116. 5261: 5257: 5251: 5243: 5218: 5214: 5210: 5206: 5200: 5183: 5179: 5173: 5141:(1): 30–37. 5138: 5134: 5128: 5120: 5083: 5079: 5073: 5037: 5033: 5029: 5023: 4998: 4994: 4988: 4953: 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