▁ty phi . ▁ ▁Sign s ▁and ▁sympt oms ▁ ▁Sign s ▁and ▁sympt oms ▁include ▁fe ver , ▁head ache , ▁mus cle ▁pain , ▁c ough , ▁and ▁g astro int est inal ▁sympt oms . ▁More ▁vir ul ent ▁stra ins ▁of ▁O . ▁ts uts ug am ush i ▁can ▁cause ▁hem or rh aging ▁and ▁int ra vas cular ▁co ag ulation . ▁Mor b ill iform ▁r ash , ▁es char , ▁spl en om eg aly , ▁and ▁l ym ph aden op ath ies ▁are ▁typical ▁signs . ▁Le uk open ia ▁and ▁ab normal ▁li ver ▁function ▁tests ▁are ▁commonly ▁seen ▁in ▁the ▁early ▁phase ▁of ▁the ▁ill ness . ▁P neum on itis , ▁en ce phal itis , ▁and ▁my oc ard itis ▁occur ▁in ▁the ▁late ▁phase ▁of ▁ill ness . ▁It ▁has ▁particularly ▁been ▁shown ▁to ▁be ▁the ▁most ▁common ▁cause ▁of ▁ac ute ▁en ce phal itis ▁synd rome ▁in ▁Bi har , ▁India . ▁ ▁C aus es ▁ ▁Sc r ub ▁ty ph us ▁is ▁transm itted ▁by ▁some ▁species ▁of ▁trom b icul id ▁mit es ▁(" ch ig gers ", ▁particularly ▁Le pt ot rom bid ium ▁del ien se ), ▁which ▁are ▁found ▁in ▁areas ▁of ▁heavy ▁scr ub ▁veget ation . ▁ ▁The ▁b ite ▁of ▁this ▁m ite ▁leaves ▁a ▁characteristic ▁black ▁es char ▁that ▁is ▁useful ▁to ▁the ▁doctor ▁for ▁making ▁the ▁diagn osis . ▁ ▁Sc r ub ▁ty ph