Apart from the classical
presentation as an acute febrile illness, many other unusual
clinical manifestations are reported. In countries where
other febrile illnesses are also commonly seen, awareness
of these unusual manifestations may alert the clinician to
a diagnosis of scrub typhus, enabling early administration
of appropriate antibiotics. Experience with the disease
in pregnancy is limited to a few case reports but vertical
transmission has been demonstrated. Prognostic indicators
for severe disease cannot be established with the available
evidence due to limited sample sizes and conflicting results.