DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for scrub typhus — screening already-approved drugs against its 4-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleScrub typhus maps to a 4-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
approvedDoxycyclineApproved drug
Structures already discussed alongside scrub typhus in the retrieved literature, rendered from public PubChem SMILES. Which drugs appear here reflects the evidence found, not a ranked prediction.
Molecular view
Crystal structure of Alpha1-antichymotrypsin variant DBS-I1: a drug-binding serpin for doxycycline — Doxycycline has a real, experimentally solved structure in complex with this target (PDB 5OM2, 1.47 Å). This is the drug's own deposited structure, not a prediction, and confirms it is a structurally characterised molecule rather than an untested guess.
Loading structure…
helix sheet dxtdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 5OM2 · 1.47 Å · ligand Doxycycline (DXT). Experimental structure, not a prediction.
What the evidence adds up to
Scrub typhus, caused by Orientia tsutsugamushi, is a significant cause of acute febrile illness across Asia, with a pooled seroprevalence of 10.73% among healthy individuals and 22.58% among febrile patients, based on a systematic review of 663 articles from 29 countries. The same review reported a median mortality of 5.00% among hospital inpatients, with a range from 0.00% to 56.00%, and 2.17% among outpatients. In a South Indian study of 154 confirmed patients, multi-organ dysfunction occurred in 38.3% and the fatality rate was 7.8%. Among 30 Thai children, all responded well to doxycycline or chloramphenicol, with an average time to defervescence of 29 hours. No randomised controlled trials comparing different antibiotics or durations of therapy were identified in these abstracts.
Clinical presentation is often non-specific. An eschar was found in 55% of 154 South Indian patients and in 68% of 30 Thai children. Other common signs in the paediatric series included lymphadenopathy (93%), hepatomegaly (73%), and maculopapular rash (30%). A case-control study from northern China identified four independent risk factors for severe complications: duration of illness before effective antibiotic therapy (odds ratio 2.287), presence of a rash (OR 3.694), lymphadenopathy (OR 2.438), and a platelet count below 100×10⁹/L (OR 2.226). Hypotension requiring vasoactive agents was an independent predictor of mortality in the South Indian cohort. The 2019 case series of five fatalities in India stressed that the disease is often fatal without treatment but has a high cure rate if diagnosed early and treated specifically.
The systematic review identified agricultural work, vegetation exposure, outdoor activities, risky personal health habits, and proximity to rodents, livestock, or poultry as significant risk factors. In South India, phylogenetic analysis of 26 samples showed 65% clustering with the Kato-like group and 31% with the Karp-like group. The 2023 commentary noted that prevalence is increasing globally and that clinical suspicion among healthcare professionals has improved diagnosis and management, but emphasised the need for enhanced surveillance, rapid diagnosis, and appropriate antibiotic use. What remains missing are prospective randomised trials to establish optimal antibiotic regimens and durations, validated rapid point-of-care diagnostics for field use, and studies that stratify patients by circulating strain or by severity at presentation to guide treatment intensity.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
International Journal of Infectious Diseases · 2013 · 141 citations · open access
Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome
AbstractOBJECTIVES: This study sought to document the clinical and laboratory manifestations, genetic variability, and outcomes of scrub typhus, an often severe infection caused by Orientia tsutsugamushi, in South India. METHODS: Patients admitted to a large teaching hospital with IgM ELISA-confirmed scrub typhus were evaluated. Clinical examination with a thorough search for an eschar, laboratory testing, chest X-ray, and outcome were documented and analyzed. Additionally, a 410-bp region of the 56-kDa type-specific antigen gene of O. tsutsugamushi was sequenced and compared with isolates from other regions of Asia. RESULTS: Most of the 154 patients evaluated presented with fever and non-specific symptoms. An eschar was found in 86 (55%) patients. Mild hepatic involvement was seen in most, with other organ involvement including respiratory, cardiovascular, and renal. Multi-organ dysfunction was noted in 59 (38.3%), and the fatality rate was 7.8%. Hypotension requiring vasoactive agents was found to be an independent predictor of mortality (p<0.001). The phylogeny of 26 samples showed 17 (65%) clustering with the Kato-like group and eight (31%) with the Karp-like group. CONCLUSIONS: The presentation of scrub typhus can be variable, often non-specific, but with potentially severe multi-organ dysfunction. Prompt recognition is key to specific treatment and good outcomes. Further study of the circulating strains is essential for the development of a successful vaccine and sensitive point-of-care testing.
The Pediatric Infectious Disease Journal · 2003 · 119 citations
Epidemiologic, clinical and laboratory features of scrub typhus in thirty Thai children
AbstractBACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is common in Asia. Although serologic surveys suggested that as many as one-fourth of cases of scrub typhus might be in children, very few reports of childhood scrub typhus are available in the medical literature. OBJECTIVES: To document the clinical, laboratory and epidemiologic characteristics of pediatric patients with scrub typhus. METHODS: From January 1, 2000 to December 31, 2001, all pediatric patients at Chiang Mai University Hospital who had obscure fever for >5 days were tested for indirect immunofluorescent antibody (IFA) against Orientia tsutsugamushi, the causative organism of scrub typhus. Scrub typhus was diagnosed on the basis of either a single IFA titer against O. tsutsugamushi > or =1/400 or a 4-fold or greater rise in IFA titer to at least 1/200. RESULTS: Thirty children with scrub typhus were enrolled. Most were diagnosed during the rainy months of June to November. Common physical signs included lymphadenopathy (93%), hepatomegaly (73%), eschar (68%), conjunctival hyperemia (33%), maculopapular rash (30%) and splenomegaly (23%). Eleven patients had interstitial pneumonitis and 1 patient had meningitis. All patients responded well to doxycycline or chloramphenicol. The average interval to defervescence after treatment was 29 h (range, 6 to 72). CONCLUSIONS: Clinical and epidemiologic features of 30 pediatric patients with scrub typhus are reported in a prospective study. The presence of eschar was helpful in making the diagnosis. Complications included pneumonitis and meningitis. All cases responded well to treatment with antibiotic.
International Journal of Infectious Diseases · 2024 · 36 citations · open access
Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis
AbstractOBJECTIVES: Scrub typhus is underdiagnosed and underreported but emerging as a global public health problem. We aimed to provide the first comprehensive review on the seroprevalence, incidence, mortality of and risk factors for scrub typhus. METHODS: We searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and other databases. Trended incidence and median mortality were calculated and pooled seroprevalence and risk factors for scrub typhus were evaluated using the random-effects meta-analysis. RESULTS: We included 663 articles from 29 countries/regions. The pooled seroprevalence was 10.73% (95%CI 9.47-12.13%) among healthy individuals and 22.58% (95%CI: 20.55%-24.76%) among febrile patients. Mainland China reported the highest number of cases and South Korea and Thailand had the highest incidence rates. Median mortalities were 5.00% (range: 0.00-56.00%) among hospital inpatients, 6.70% (range: 0.00-33.33%) among patients without specified admission status and 2.17% (range: 0.00-22.22%) among outpatients. The significant risk factors included agricultural work, specific vegetation exposure, other outdoor activities, risky personal health habits, and proximity to rodents, livestock, or poultry. CONCLUSIONS: Our comprehensive review elucidates the significant yet variable burden of scrub typhus across different regions, underscoring its emergence as a critical public health concern globally.
International Journal of Infectious Diseases · 2014 · 27 citations · open access
Risk factors associated with severe scrub typhus in Shandong, northern China
AbstractOBJECTIVES: The aim of this study was to identify risk factors associated with severe scrub typhus, in order to provide a reference for clinical decision-making. METHODS: A case-control study was conducted of scrub typhus patients who presented at local hospitals between 2010 and 2013. In total, 46 patients with severe scrub typhus complications (cases) and 194 without severe complications (controls) were included. RESULTS: There were significant differences in the duration of illness before effective antibiotic therapy, lymphadenopathy, rash, blood platelet count, white blood cell (WBC) count, percentage neutrophils, and percentage lymphocytes between the case and control groups. Multivariate analysis demonstrated that the following four factors were significantly associated with the severe complications of scrub typhus: (1) duration of illness before effective antibiotic therapy (odds ratio (OR) 2.287, 95% confidence interval (CI) 1.096-4.770); (2) the presence of a rash (OR 3.694, 95% CI 1.300-10.495); (3) lymphadenopathy (OR 2.438, 95% CI 1.090-5.458); (4) blood platelet count <100×10(9)/l (OR 2.226, 95% CI 1.002-4.946). CONCLUSIONS: This study indicates that improved diagnosis and timely treatment are important factors for the prevention of severe scrub typhus. When scrub typhus patients present with a rash, lymphadenopathy, or blood platelet count <100×10(9)/l, clinicians should be alert to the appearance of severe complications.
The Indian Journal of Medical Research · 2019 · 20 citations · open access
Mortality due to scrub typhus – report of five cases
AbstractScrub typhus is largely ignored in India particularly during outbreaks of viral fever. The disease course is often complicated leading to fatalities in the absence of treatment. However, if diagnosed early and a specific treatment is initiated, the cure rate is high. We report here five cases of scrub typhus to highlight the fact that high clinical suspicion for such a deadly disease is an absolute necessity.
AbstractScrub typhus (ST) infection is one of the most significant causes of acute undifferentiated febrile illness, and its prevalence has been increasing across the globe. Clinical suspicion and growing clinical understanding among healthcare professionals have resulted in the rapid diagnosis and effective management. Since ST has the potential to cause multiorgan failure and a higher mortality rate, it is critical to enhance surveillance, make rapid diagnosis, and administer antibiotics appropriately.
Infection and Chemotherapy · 2023 · 9 citations · open access
Antibiotic Combination Therapy for Severe Scrub Typhus: Is It Necessary?
AbstractScrub typhus can be adequately treated with doxycycline or azithromycin unless it is treated too late. Such cases present as severe scrub typhus, and their treatment remains a challenging problem. In this article, we briefly review the literature on the treatment of scrub typhus and the limitations of the combination of doxycycline and azithromycin. Several options are suggested for further study in the treatment of severe scrub typhus (such as encephalitis, myocarditis, and pneumonia), including dose escalation of doxycycline, the adjuvant use of steroids, the selective use of beta-lactam antibiotics, and the use of tigecycline.
Research & Review Management of Emergency and Trauma Nursing · 2024 · 0 citations · open access
Case Study Presentation on Scrub Typhus
AbstractScrub typhus, caused by Orientia tsutsugamushi, is a significant health concern in Asia-Pacific, particularly in the "tsutsugamushi triangle," impacting over 1 billion people. Despite its high fatality risk, it remains neglected in research and healthcare policy. Case Scenario: A mason from Namagiripettai passed away due to scrub typhus at SGMKMCH after initially discharging himself prematurely. Epidemiological Determinants: The disease is transmitted through infected mites without human-to-human transmission. Clinical Features and Diagnosis: Symptoms include high-grade fever, headache, muscle pain, and eschar development. Diagnosis is based on serology, biopsy, and imaging. Control Measures: Treatment involves doxycycline and Azithromycin. Preventive steps include vector control, personal prophylaxis, and antibiotic prophylaxis.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
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