American Journal of Medical Case Reports. 2015, 3(1), 20-22
DOI: 10.12691/AJMCR-3-1-8
Atypical Case of Scrub Typhus
Takaaki Yoshimoto1, and Taiji Yoshimoto1
1Internal Medicine, Hitachi-Ota City Kegano Clinic, Ibaraki, Japan
Pub. Date: January 14, 2015
Cite this paper
Takaaki Yoshimoto and Taiji Yoshimoto. Atypical Case of Scrub Typhus.
American Journal of Medical Case Reports. 2015; 3(1):20-22. doi: 10.12691/AJMCR-3-1-8
Abstract
Scrub typhus, also called tsutsugamushi disease in Japan, is one of the most common rickettsial diseases in this country. Fever, skin rash, eschar and elevated hepatic enzymes are main clinical features of scrub typhus. We present the case of a 55 year-old woman contracted with this infection without skin eruption and abnormal liver function. The finding of an unusual eschar helped us to make a correct diagnosis. The fever subsided within 24 hours after minocyline therapy. Scrub typhus of Kuroki serotype was confirmed by indirect immunoperoxidase assay and nested polymerase chain reaction with her whole blood and eschar.
Keywords
rickettsia, scrub typhus , eschar, skin eruption
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References
[1] | Amano K, Tamura A, Ohashi N, Urakami H, Kaya S, Fukushi K. Deficiency of peptidoglycan and Popolysaccharide components in Rickettsia tsutsugamushi. Infect immune. 1987; 55 (9): 2290-2. |
|
[2] | Moron CG. Identification of the target cells of Orientia Tsutsugamushi of scrub typhus in human cases. Mod Pathol. 2001; 14: 752-9. |
|
[3] | IASR Infectious Agent Service Report Scrub Typhus (tsutsugamushi disease) in Japan 1996-2000 Available: http://idsc.nih.go.jp/iasr/22/259/tpc259.html. |
|
[4] | Ogawa M, Hagiwara T, Kishimoto T, Shiga S, Yoshida Y, Furuya Y,colon. Scrub typhus in Japan: epidemic-ology and clinical features of cases reportedin 1998. Am J Trop Med Hyg. 2002; 67 (2): 162-165. |
|
[5] | Furuya Y, Yoshida Y, Katayama T, Yamamoto S and Kawamura, A.Jr. Serotype-specific amplication of Rickettsia tsutsugamushi DNA by nested po- lymerase chain reaction. J. Clin. Microbiol. 1993; 31: 1637-1640. |
|
[6] | Suto T. The Story of New Tsutsugamushi Disease (in Japanese), Present status of tsutsugamushi disease in Japan (in Japanese). Akita, Japan: Mumei-Syuppan Ltd. |
|
[7] | IASR Infectious Agent Service Report Tsutsugamushi disease and Japanese spotted fever. 2006-2009. Available: http://idsc.nih.go.jp/iasr/31/363/tpc363.html |
|
[8] | Kim D-M, Yun NR, Neupane GP, Shin SH, Ryu SY, et al. Differences in Clinical Features According to Boryoung and Karp genotypes of Orientia tsutsugamushi. Plos ONE 2011; 6(8):e22731. |
|
[9] | Berman SJ, Kundin WD. Scrub typhus in South Vietnam. A study of 87 cases. Ann Intern Med. 1973; 79(1): 26-30. |
|
[10] | Hu ML, Liu JW, Wu KL, Lu SN, Chiou SS, Kuo CH. Short Report: Abnormal liver function in scrub typhus. Am J Trop Med Hyg. 2005; 73(4): 667-68. |
|
[11] | Chanta C, Triatanapa K, Ratanasirichup P, Mahaprom W. Hepatic dysfunction in pediatric scrub typhus. J Med Assoc Thai. 2007; Nov; 90(11): 2366-69. |
|
[12] | Lee SH, Kim DM, Cho Y, Yoon S, Shim S. The usefulness of eschar PCR for the diagnosis of scrub typhus. J Clinic Microbiol 2006; 44: 1169-1171. |
|
[13] | Sugita M, Shigeta M, Miyake Y, Sakamoto T, Aoki S, Matsuoka R, et al. Sero-negative tsutsugamushi disease diagnosed by polymerase chain reaction. Nihon kyobu Shikkan Gakkai Zasshi. 1997; 35 (12): 1368-71. |
|