Yijia Guo, Yi Niu, Nihui Zhang, Xiao Han, Liyuan Zhang, Yongguo Du, Lifen Han, Xiuying Tian, Zhao Xu, Gaoyu Wang, Kwok-Yung Yuen, Jasper Fuk-Woo Chan, Dahua Xu, Feifei Yin
Integrated single-cell RNA sequencing, spectral flow cytometry, immune-receptor repertoire profiling, and plasma proteomics revealed coordinated peripheral immune remodeling during acute scrub typhus. Patients exhibited expansion of cytotoxic, clonally amplified CD8+ T cells with exhaustion-associated features, depletion and apoptosis of CD4+ T cells, B-cell contraction with enhanced plasmablast/plasma-cell differentiation, and inflammatory myeloid remodeling. CD14+CXCR6+ and CD14+GNLY+ myeloid-cell frequencies positively correlated with bacterial burden, defining prominent immune features of acute Orientia tsutsugamushi infection.