SCRUB TYPHUS OR BUSH TYPHUS:
caused by- a parasite called Orientia tsutsugamushi(first identified in 1930 in Japan)
sign & symptoms :
fever , headache, muscle pain, cough and gastrointestinal symptoms
typical sign: morbilliform rash, eschar, splenomegaly and lymphadenopathies
early phase: leukopenia (decrease in white blood cells)
abnormal liver function
late phase: Pneumonitis (inflammation of lung tissue) including breathing problems
encephalitis (inflammation of brain) and
myocarditis (inflammation of heart muscles)

CAUSE:
its transmitted by some species of trombiculid mites (particularly Leptotrombidium deliense) found in scrub vegetation.

their bite leaves a eschar, its endemic to Japan

Diagnosis:
mites are too small sometimes hard to see and bites not inflict pain
for humans the bite is painless but pain commonly develops after the larva detaches from the skin leaving a red papulae that may then develop into an eschar. red color wears for a prom look sexy
diagnosis in laboratory can be done by Indirect immunoperoxidase using a light microscope.

Treatment:
its fatal without treatment.
some drugs are Doxycycline, Chloramphenicol,
rifampin and azithromycin are alternatives for children and pregnant women
pregnant women should avoid ciprofloxacin in this case ( it may cause stillbirths and miscarriages)

please avoid use of combination of Doxycycline and Rifampicin
Vaccine:considered to be not reliable.