Coinfection of Severe Fever with Thrombocytopenia Syndrome and Scrub Typhus in Patients with Tick-Borne Illness

Sang Hyun Ra Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Ji Yeun Kim Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Hye Hee Cha Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Ji-Soo Kwon Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Hyun-Jung Lee Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Na Young Jeon Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Jae Kim Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Yong Pil Chong Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Sang-Oh Lee Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Sang-Ho Choi Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Yang Soo Kim Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Jun Hee Woo Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Sung-Han Kim Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Severe fever with thrombocytopenia syndrome (SFTS) and scrub typhus are the most common tick-borne diseases in South Korea. However, few studies have systematically examined the simultaneous presence of the two diseases. We found that two (4.9%) of 41 patients with suspected and confirmed SFTS had evidence of coinfection with scrub typhus. In addition, two (3.6%) of 55 suspected and confirmed scrub typhus patients were identified to have coinfection with SFTS. Our data suggest that diagnostic evaluation for coinfection in patients with tick-borne illness and empirical doxycycline treatment in patients with SFTS may be warranted in areas endemic for both diseases until coinfection with scrub typhus is ruled out.

Author Notes

Address correspondence to Sung-Han Kim, Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, Republic of Korea. E-mail: kimsunghanmd@hotmail.com

Financial support: This study was supported by grants from the Government-wide R&D Fund Project for Infectious Disease Research (GFID), Republic of Korea (grant no. HG18C0037) and from the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (grant no. NRF-2017R1A6A3A11031093).

Authors’ addresses: Sang Hyun Ra, Ji Yeun Kim, Hye Hee Cha, Ji-Soo Kwon, Hyun-Jung Lee, Na Young Jeon, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, and Sung-Han Kim, Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, E-mails: jesus4274@naver.com, aeki22@snu.ac.kr, heyhe0102@naver.com, kwonjs92@kaist.ac.kr, silverspec@naver.com, dognaf@naver.com, nahani99@gmail.com, drchong@amc.seoul.kr, soleemd@amc.seoul.kr, sangho@amc.seoul.kr, yskim@amc.seoul.kr, yeom3477@daum.net, and kimsunghanmd@hotmail.com.

These authors contributed equally to this work.

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