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Identification of mite and tick bite sites provides important clinical information. The predominant mite species in Korea associated with scrub typhus are Leptotrombidium pallidum and Leptotrombidium scutellare. The most abundant tick species is Haemaphysalis longicornis. To date, there has been no comparative study on preferred bite sites between mites and ticks in humans. This study included a review of medical records and a field study. For mite bite sites, eschars were checked on 506 patients with scrub typhus, confirmed by indirect immunofluorescence assay or nested polymerase chain reaction on the 56-kDa type-specific antigen gene of Orientia tsutsugamushi. Tick bite sites were identified and marked on a diagram for 91 patients who experienced tick bites within the previous year through a field epidemiological investigation. The mite and tick bite sites in Koreans were compared. The most frequently observed mite bite sites were the anterior chest, including the axillae (29.1%) and the abdominal region, including the inguinal area (26.1%). Tick bite sites were most frequent on the lower extremities (33.0%), followed by the abdominal region, including the inguinal area (26.4%), and upper extremities (26.4%). The distribution was significantly different between mite and tick bite sites (P < 0.001). There was a statistically significant difference in the mite bite (P = 0.001), but not tick bite sites (P = 0.985), between men and women. This is the first report on the differences between tick and mite bite sites, and may help clinicians reach a rapid diagnosis of mite- or tick-borne infection.
Financial support: This study was supported by research funds from Chosun University, 2013.
Authors' addresses: Mi-Sun Jang, Dong-Min Kim, and Na Ra Yoon, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Choon-Mee Kim, Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea, E-mail: firstname.lastname@example.org. Mi Ah Han, Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, South Korea, E-mail: mahan@Chosun.ac.kr. Hyun-Kuk Kim, Department of Pulmonary and Critical Care Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea, E-mail: email@example.com. Won Sup Oh, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea, E-mail: firstname.lastname@example.org. Hee-Jung Yoon, Department of Infectious Diseases, Seoul Metropolitan Government Seobuk hospital, Seoul, Korea, E-mail: email@example.com. Seong-Heon Wie, Department of Internal Medicine, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Seoul, South Korea, E-mail: firstname.lastname@example.org. Jian Hur, Department of Internal Medicine, Yeungnam University, College of Medicine, Daegu, South Korea, E-mail: email@example.com.