Browse > Article

Scrub Typhus:A Prospective Study of 76 Cases  

Kim, Dong-Min (Division of Infectious Diseases, Departments of Internal Medicine, College of Medicine, Chosun University)
Kim, Hyun-Lee (Division of Infectious Diseases, Departments of Internal Medicine, College of Medicine, Chosun University)
Park, Chi-Young (Division of Infectious Diseases, Departments of Internal Medicine, College of Medicine, Chosun University)
Yoon, Sung-Ho (Division of Infectious Diseases, Departments of Internal Medicine, College of Medicine, Chosun University)
Song, Hyeon-Je (Jeollanam-do Institute of Health and Environment)
Shim, Soo-Kyoung (Korea Center for Disease Control and Prevention)
Publication Information
Infection and chemotherapy / v.38, no.4, 2006 , pp. 186-191 More about this Journal
Abstract
Background:Orientia tsutsugamushi spreads to the entire body through the blood and lymphatics, and it induces vasculitis that results in the patients manifesting symptoms of systemic organ involvement. Materials and Methods:We conducted a prospective study to evaluate the clinical manifestations and the change of the laboratory results after instituting treatment for scrub typhus. Results:Most patients presented with fever (100%), malaise (96.1%) and thirst (96.1%). It was remarkable that most patients presented with severe thirst, except for 3 healthy, young patients. This thirst was persistent even after the resolution of fever. The renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. For the blood testing, it was deteded that the CRP, and LDH were elevated in most patients (95.9% and 100% respectively). DIC could be diagnosed in 95.5% of the patients at the time of admission Conclusion:Most patients presented with fever, malaise and severe thirst, and the renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. DIC was observed in most of our patients, but hemorrhage and infarction were not present. CRP showed a rapid improvement, nonetheless, the LDH and DIC test results improved slowly.
Keywords
Scrub typhus; Signs and symptoms; Clinical chemistry tests;
Citations & Related Records
Times Cited By KSCI : 5  (Citation Analysis)
연도 인용수 순위
1 Kim SJ, Chung IK, Chung IS, Song DH, Park SH, Kim HS, Lee MH: The clinical significance of upper gastrointestinal endoscopy in gastrointestinal vasculitis related to scrub typhus. Endoscopy 32: 950-5, 2000   DOI   ScienceOn
2 World Health Organization (WHO): WHO recommended surveillance standards. 2nd ed. Available at http://www.who.int/emc-documents/surveillance/doc s/whocdscsrisr992.pdl Accessed 19 June 2004
3 Chi WC, Huang JJ, Sung JM, Lan RR, Ko WC, Chen FF: Scrub typhus associated with multiorgan failure: a case report. Scand J Infect Dis 29:634-5, 1997   DOI   ScienceOn
4 Watt G, Chouriyagune C, Ruangweerayud R, Watcharapichat P, Phulsuksombati D, Jongsakul K, Teja-Isavadharm P, I3hodhidatta D, Corcoran KD, Dasch GA, Strickman D: Scrub typhus infections poorly responsive to antibiotics in northern Thailand. Lancet 13;348:86-9, 1996
5 Yi KS, Chong Y, Covington SC, Donahue B], Rothen RL, Rodriguez J, Arthur JD: Scrub typhus in Korea: importance of early clinical diagnosis in this newly recognized endemic area. Mil Med 158: 269-73, 1993   DOI
6 Bozeman, GW, Elisberg BL: Serological diagnosis of scrub typhus by indirect immunofluorescence. Proc Soc Exp Biol Med 112:568-7:1, 1963
7 Thap LC, Supanaranond W, Trccprascrtsuk S, Kitvatanachai S, Chinprasatsak S, Phonrat B: Septic shock secondary to scrub typhus: characteristics and complications. Southeast Asian J Trop Med Public Health 33:780-6, 2002
8 Robinson DM, Drown G, Gan E, Huxsoll DL: Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25:900-5, 1976   DOI
9 Watt G, Kantipong P, Jongsakul K, Watcharapichat P, Phulsuksombati D, Strickman D: Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial. Lancet 356: 1057-61, 2000   DOI   ScienceOn
10 Yu M, Nardella A, Pechet L: Screening tests of disseminated intravascular coagulation: guidelines for rapid and specific laboratory diagnosis. Crit Care Med 28:1777-80, 2000   DOI   ScienceOn
11 Ogawa M, Hagiwara T, Kishimoto T, Shiga S, Yoshida Y, Furuya Y, Kaiho I, Ito T, Nemoto H, Yamamoto N, Masukawa K: Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998. Am J Trop Med Hyg 67:162-5, 2002   DOI