The goal of this randomized case-control study is to analysis of effectiveness of tigecycline in scrub typhus. The main question it aims to answer are:

• [question 1]: Does tigecycline reduce fever faster than doxycycline in scrub typhus?
• [question 2]: Is the use of tigecylcine tolerable in scrub typhus? Participants will assigned as doxycycline or tigecycline groups. Researchers will compare tigecycline group with doxycycline group, using defervescence time and adverse events.

Inclusion Criteria:

• Hospitalization with a fever of 37.5℃ or higher (tympanic temperature measurement standard) and rash or scabs suspected of tsutsugamushi syndrome
• If an infectious disease specialist makes a clinical judgment and diagnoses scrub typhus
• A person who voluntarily decides to participate and agrees in writing to abide by the precautions after hearing a detailed explanation of this clinical study and fully understanding it

Exclusion Criteria:

• Patients with severe complications such as respiratory failure, pneumonia, and encephalitis (researcher determines final exclusion)

• Patients with chronic renal dysfunction

• Underweight people weighing less than 45Kg

• Immunodeficiency: Long-term use of steroids or other immunosuppressive drugs, patients undergoing chemotherapy, etc. (Researcher determines final exclusion)

• Pregnant women

• Women and men of childbearing potential who are planning to become pregnant during the clinical study period and for 3 months after the end of the clinical study, or who are unwilling to use the following appropriate contraceptive methods*

  * Intrauterine device [IUD (Intrauterine device), barrier contraception method including spermicide (for female contraceptive vaginal diaphragm/vaginal sponge sponge/cervical cap) and double barrier method (for male use) Excluding simultaneous use of condoms and female condoms), sterilization (vasectomy, vasectomy, tubal ligation, etc.)

• If you cannot take the medicine orally

• Patients already using other anti-rickettsial drugs (rifampin, chloramphenicol, macrolides, quinolones, tetracyclines)

• Patients with shock or multiple organ failure requiring vasopressor/vasoconstrictor, impaired consciousness, respiratory failure requiring mechanical ventilation, and renal dysfunction requiring hemodialysis](streamdown:incomplete-link)