Scrub typhus or bush typhus is a mite-borne infectious disease caused by Orientia tsutsugamu- 
shi (formerly Rickettsia tsutsugamushi), a gram-negative coccobacillus antigenic distinct from trickett
sia typhus group. Infection begins insidiously with headache, anorexia, and malaise, or start abruptly 
with chills, severe headache, myalgias and high fever or pneumonitis, meningoencephalitis, jaundice
meningitis and/or meningo-encephalitis or even spontaneous pregnancy risky outcomes. An Escher or 
dark rash may develop in a subset of patients. Severe complicated infection can range from mild and 
signs symptoms to multi-organ systemic failure in elderly delayed treated patients. Diagnosis includes 
serology, biopsy, culture, and PCR. Scrub typhus as anon-specific clinical disease must be differenti
ated from other vector-borne diseases as malaria, dengue, chikungunya, other rickettsia diseases, and 
insect bites as well as leptospirosis and enteric fever as typhoid.