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High Seroprevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae among Scrub Typhus Patients in South Korea

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  • 1 Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea;
  • | 2 Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
  • | 3 Division of Microbiology, Jeollabukdo Institute of Health and Environment Research, Imsil, Republic of Korea
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Scrub typhus is an acute febrile illness caused by the obligate intracellular organism Orientia tsutsugamushi, endemic to South Korea. The course of scrub typhus can range from a self-limiting disease to a fatal illness. Serological cross-reactivity has been reported with other intracellular organisms, including Rickettsia species, Chlamydophila species, and Mycoplasma pneumoniae. We conducted a retrospective study to assess the current seroprevalence of M. pneumoniae IgM and Chlamydia pneumoniae IgM in scrub typhus patients in South Korea. We enrolled 150 patients with suspected rickettsial disease over the course of 2 years. Of these patients, 60 were confirmed to have scrub typhus and had paired acute and convalescent serum. Among the 60 scrub typhus patients, 40 (66.7%) had M. pneumoniae IgM and 19 (31.7%) had C. pneumoniae IgM in acute- or convalescent phase sera. The seroconversion rates of M. pneumoniae IgG and IgM were 16.7% and 33.3%, respectively. The seroconversion rates of C. pneumoniae IgG and IgM were 8.3% and 11.7%, respectively. Compared with previous study results, this may indicate a relatively high seroprevalence of M. pneumoniae IgM and C. pneumoniae IgM in scrub typhus patients, indicating possible misdiagnosis of M. pneumoniae and C. pneumoniae infections in non-endemic scrub typhus areas.

Author Notes

Address correspondence to Chang-Seop Lee, Department of Internal Medicine, Chonbuk National University Medical School, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea. E-mail: lcsmd@jbnu.ac.kr

Financial support: This research was supported with research funds from Chonbuk National University in 2018 and by Biomedical Research Institute, Chonbuk National University Hospital, and by the Basic Science Research Programs (NRF-2015R1D1A1A01060251 and 2018R1D1A3B07049557) of the National Research Foundation of Korea, which are funded by the Ministry of Education.

Authors’ addresses: Joo-Hee Hwang, Mir Jeo, and Chang-Seop Lee, Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea, E-mails: zany78@naver.com, preciousmir@gmail.com, and lcsmd@chonbuk.ac.kr. Cheon-Hyeon Kim, Division of Microbiology, Jeollabukdo Institute of Health and Environment Research, Imsil, Republic of Korea, E-mail: kchyeon@korea.kr.

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