The association of O. tsutsugamushi with circulating mononuclear cells in vivo [16], and previous findings of elevated soluble L-selectin levels in patients with scrub typhus, are both suggestive of mononuclear cell activation [9], and CRP, the level of which is more prominently increased in scrub typhus, has been shown to facilitate monocyte–endothelial cell interactions [17] and to promote PAI-1 and TF formation [18]. The gene discussed is SERPINE1; the disease is scrub typhus.