title: Differences in clinical features according to Boryoung and Karp genotypes of Orientia tsutsugamushi.
abstract: BACKGROUND
  Scrub typhus is an infectious disease caused by Orientia tsutsugamushi. The differences in virulence of O. tsutsugamushi prototypes in humans are still unknown. We investigated whether there are any differences in the clinical features of the Boryoung and Karp genotypes.
  
  
  RESULTS
  Patients infected with O. tsutsugamushi, as Boryoung and Karp clusters, who had visited 6 different hospitals in southwestern Korea were prospectively compared for clinical features, complications, laboratory parameters, and treatment responses. Infected patients in the Boryoung cluster had significantly more generalized weakness, eschars, skin rashes, conjunctival injection, high albumin levels, and greater ESR and fibrinogen levels compared to the Karp cluster. The treatment response to current antibiotics was significantly slower in the Karp cluster as compared to the Boryoung cluster.
  
  
  CONCLUSIONS
  The frequency of occurrence of eschars and rashes may depend on the genotype of O. tsutsugamushi.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea. drongkim@chosun.ac.kr
authors.forename: Dong-Min
authors.initials: DM
authors.lastname: Kim
authors.forename: Na Ra
authors.initials: NR
authors.lastname: Yun
authors.forename: Ganesh Prasad
authors.initials: GP
authors.lastname: Neupane
authors.forename: Sung Heui
authors.initials: SH
authors.lastname: Shin
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Ryu
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Wie
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Kim
authors.forename: Chang Youl
authors.initials: CY
authors.lastname: Lee
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Choi
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D006801:Humans; D048628:Ketolides / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D011446:Prospective Studies; D056910:Republic of Korea; D012293:Rifampin / Q000627:therapeutic use; D012612:Scrub Typhus / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D012703:Serotyping; D013045:Species Specificity; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D048628:Ketolides; C106791:telithromycin; D004318:Doxycycline; D012293:Rifampin