Differentiating scrub typhus from other forms of typhus as well as from fever, typhoid
and meningococcal infections is often difficult during the first several days before theinitial rash appears. The most common signs are similar to a variety of other infectious
diseases (typhoid fever, murine typhus, leptospirosis and dengue fever, etc.) which
should be taken into consideration (30).
The geographical location of scrub typhus, the initial sore caused by the chigger
bite, and the occurrence of specific proteins capable of destroying the organism
(antibodies) in the blood, provide helpful clues and are useful in establishing the
diagnosis.
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