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Acute Fulminant Myocarditis Following Scrub Typhus Infection

쯔쯔가무시병에서 발생된 급성 전격성 심근염 1예

  • Han, Dong Jae (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Park, Hee Soon (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Kim, Dae Yeon (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Kang, Hyo Chul (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Rhee, Ho Sung (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Lee, Se Whan (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital) ;
  • Na, Ju Ock (Department of Internal Medicine, Soonchunhang University College of Medicine, Department of Pulmonology, Soonchunhang University Cheonan Hospital)
  • 한동재 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 박희순 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 김대연 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 강효철 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 이호성 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 이세환 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과) ;
  • 나주옥 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 호흡기내과)
  • Received : 2013.05.10
  • Accepted : 2013.08.06
  • Published : 2013.12.01

Abstract

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi that is characterized by focal or disseminated vasculitis and perivasculitis. Scrub typhus can have fatal complications, such as acute respiratory distress syndrome, septic shock, and acute kidney injury. However, there are few reports of fatal myocarditis caused by scrub typhus. We present a case of acute fatal myocarditis combined with acute kidney injury complicating scrub typhus.

쯔쯔가무시병은 국내에서 대표적인 가을철 열성 질환의 하나이며 이로 인한 호흡부전이나 신부전은 널리 알려져 있지만 심근염은 질병의 위중함에 미루어 잘 알려져 있지 않은 합병증이다. 저자들은 85세 고령의 여성에서 쯔쯔가무시병을 적절하게 빠른 시일에 진단하였으며 그 후 항균제 투약 등 적절한 처치를 시행하였음에도 불구하고 급성 심근염 및 급성 신부전으로 사망한 예를 보고하였다.

Keywords

References

  1. Tsay RW, Chang FY. Acute respiratory distress syndrome in scrub typhus. QJM 2002;95:126-128. https://doi.org/10.1093/qjmed/95.2.126
  2. Levine HD. Pathologic study of thirty-one cases of scrub typhus fever with especial reference to the cardiovascular system. Am Heart J 1946;31:314-328. https://doi.org/10.1016/0002-8703(46)90313-4
  3. Yotsukura M, Aoki N, Fukuzumi N, Ishikawa K. Review of a case of tsutsugamushi disease showing myocarditis and confirmation of Rickettsia by endomyocardial biopsy. Jpn Circ J 1991;55:149-153. https://doi.org/10.1253/jcj.55.149
  4. Kim JM, Choi ES, Kim HA, Ryu SY. A case of acute fulminant myocarditis in scrub typhus. Keimyung Med J 2011;30:141-145.
  5. Saah AJ. Orientia tsutsugamushi (scrub typhus). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Disease. 5th ed. Philadelphia: Churchill Livingstone, 2000:2056-2057.
  6. Brown GW, Shirai A, Rogers C, Groves MG. Diagnostic criteria for scrub typhus: probability values for immunofluorescent antibody and Proteus OXK agglutinin titers. Am J Trop Med Hyg 1983;32:1101-1107. https://doi.org/10.4269/ajtmh.1983.32.1101
  7. Feldman AM, McNamara D. Myocarditis. N Engl J Med 2000;343:1388-1398. https://doi.org/10.1056/NEJM200011093431908
  8. Cooper LT Jr. Myocarditis. N Engl J Med 2009;360:1526-1538. https://doi.org/10.1056/NEJMra0800028
  9. Magnani JW, Dec WD. Myocarditis: current trends in diagnosis and treatment. Circulation 2006;113:876-890. https://doi.org/10.1161/CIRCULATIONAHA.105.584532
  10. Sittiwangkul R, Pongprot Y, Silviliarat S, Oberdorfer P, Jittamala P, Sirisanthana V. Acute fulminant myocarditis in scrub typhus. Ann Trop Paediatr 2008;28:149-154. https://doi.org/10.1179/146532808X302189

Cited by

  1. Acute Fulminant Myocarditis Recovered from Electro-Mechanical Dissociation in Scrub Typhus vol.39, pp.1, 2013, https://doi.org/10.12771/emj.2016.39.1.1