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Real-world utility of serological tests in patients with suspected scrub typhus in the Republic of Korea:A single-center,retrospective,observational study
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作者 Seulki Kim A Reum Kim +2 位作者 Seungjin Lim Su Jin Lee Moonsuk Bae 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2024年第6期273-280,I0004,I0005,共10页
Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult p... Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice. 展开更多
关键词 scrub typhus Serological test Immunofluorescence assay IMMUNOCHROMATOGRAPHY Rapid detecting test
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Myositis and rhabdomyolysis in scrub typhus infection: A case report
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作者 Tukaram Bolla Sushmita Bhattarai +3 位作者 Harpreet Singh Vikas Suri Ashish Bhalla Debajyoti Chatterjee 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2023年第4期187-189,共3页
Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female pres... Rationale:Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management.Scrub typhus associated myositis with rhabdomyolysis is rare.Patient concerns:A 36-year-old female presented with intermittent fever up to 38.6℃,jaundice and progressive weakness of all four limbs.Diagnosis:Scrub typhus associated myositis and rhabdomyolysis.Intervention:Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids.Outcome:Fever resolved with normalization of liver function and recovery of muscle power.Lessons:Presence of myositis and rhabdomyolysis is uncommon in scrub typhus;high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus. 展开更多
关键词 scrub typhus MYOSITIS RHABDOMYOLYSIS DOXYCYCLINE Transaminitis VASCULITIS
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Epidemiology and clinico-laboratory manifestations of scrub typhus in Hadoti region of Rajasthan,India:A cross-sectional study
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作者 Pankaj Jain Manoj Sharma +1 位作者 Manoj Seval Pramod Meena 《Journal of Acute Disease》 2023年第2期57-60,共4页
Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus betw... Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022.Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody.The data about demography,vital parameters,and lab investigations were collected and analyzed.Results:Ninety-two percent of the patients were from a rural background(92%),86% were farmers and the majority were females.Most patients were 40-60 years old.The major complaints were fever(100%),myalgia(100%),headache(82%),and body swelling(80%).Major complications were pneumonia(68%),multiple organ dysfunction syndrome(62%),hepatitis(44%),and acute kidney injury(42%).Triglyceride levels were>200 mg/dL in 80% of patients,albumin<3.5 g/dL in 98% and eschar mark was present in 24%of patients.Conclusions:Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality.Increasing awareness regarding disease in endemic regions,early screening of patients,and treatment as early as possible could help prevent the patient from severe life-threatening complications. 展开更多
关键词 scrub typhus EPIDEMIOLOGY Eschar mark Multiple organ dysfunction syndrome
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A review of the epidemic and clinical study on scrub typhus in China(2010-2020)
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作者 XIE Xiao-fei WANG Gao-yu +6 位作者 HUANG Yi TANG Chuan-ning PENG Ruo-yan HU Xiao-yuan DU Jiang QIN Ai-ping YIN Fei-fei 《Journal of Hainan Medical University》 CAS 2023年第19期57-61,共5页
Scrub typhus is an acute febrile vector-borne zoonotic disease caused by the obligate intracellular growth bacterium Orientia tsutsugamushi(Ot).Mites are the primary vectors and rodents play a pivotal role in the tran... Scrub typhus is an acute febrile vector-borne zoonotic disease caused by the obligate intracellular growth bacterium Orientia tsutsugamushi(Ot).Mites are the primary vectors and rodents play a pivotal role in the transmission of scrub typhus.Due to the climate warming,increased human activity and other factors,cases of scrub typhus have been increased sharply during the past decade in China,especially in the northern China.To understand the incidence trend,epidemic pattern,clinical sign,diagnosis and therapy of this diseases as well as genotype evolution of Orientia tsutsugamushi,we summarized and analyzed the current knowledge of scrub typhus in China from 2010 to 2020.The data indicated that the dominate genotypes of scrub typhus in China were Karp,Kato and Gilliam.Although the disease was distributed national wide,Yunnan,Guangzhou and Fujian showed the highest incidence rate.The main vector of scrub typhus in southwest,middle east and southeast of China appeared a geographic preference respectively.Seasonal timing,age and occupation were the key factors that relate to the peak incidence of scrub typhus.Notably,farmer was the occupation with the highest risk of Ot infection.Further study on the epidemic characteristics,risk factors,diagnosis and treatments of scrub typhus will be of benefit to a comprehensive guideline for prevention and control of this ancient disease. 展开更多
关键词 scrub typhus Orientia tsutsugamushi Epidemic region TREND Clinical study
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Scrub typhus:pathophysiology,clinical manifestations and prognosis 被引量:13
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作者 Senaka Rajapakse Chaturaka Rodrigo Deepika Fernando 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2012年第4期261-264,共4页
Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagno... Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagnosis is often missed because of similarities with oilier tropical febrile infections.Many unusual manifestations are present,and these are described in this review,together with an outline of current knowledge of pathophysiology.Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis,resulting in early administration of appropriate antibiotics.Prognostic indicators for severe disease have not yet been clearly established. 展开更多
关键词 scrub typhus Orientia tsutsugamushi CLINICAL MANIFESTATIONS
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Comparison of a rapid diagnostic test and microimmunofluorescence assay for detecting antibody to Orientia tsutsugamushi in scrub typhus patients in China 被引量:2
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作者 Lijuan Zhang Si He +5 位作者 Shiwen Wang Huilan Yu Xuemei Li Derong Zhang Lei Pan Qiang Yu 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2011年第8期666-668,共3页
Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombin... Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombinant 56-kDa proteins of O.tsutsugamushi and mIFA assay were performed on 20 patients from Fujian and 13 patients from Yunnan Province,and 82 sera samples from healthy farmers in Anhui Province and Beijing City in 2009.Comparison of the RDT and mIFA assay was performed by using X test and the P level of 【0.05 was considered to be significance.Results:Among these 82 normal sera samples,the specificity of RDT was 100%for both IgM and IgG tests.In 33 samples from patients with scrub typhus,5 cases were positively detected earlier by RDT than by mIFA in IgM test,and 2 cases were positive in IgG test.Sensitivities of RDT were 93.9%and 90.9%for IgM and IgG,respectively.The sensitivity of combination lest of IgM and IgG was 100%.Geometric mean titer diluted sera from confirmed cases by IFA and RDT assay were 1:37 vs.1:113(P【0.001) in IgM test and 1:99 vs.1:279 (P【0.05) in IgG test.Conclusions:RDT is more sensitivite than mIFA in the early diagnosis of scrub typhus and it is particularly applicable in rural areas. 展开更多
关键词 scrub typhus Orientia tsutsugamushi RAPID DIAGNOSTIC test Microimmunofluorescence ASSAY
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Circulatory and hepatic failure at admission predicts mortality of severe scrub typhus patients: A prospective cohort study 被引量:2
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作者 Ashok Kumar Pannu Atul Saroch +3 位作者 Saurabh Chandrabhan Sharda Manoj Kumar Debnath Manisha Biswal Navneet Sharma 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2021年第5期209-213,共5页
Objective:To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods:This was a prospective observational cohort study conduc... Objective:To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods:This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER,Chandigarh,India.One hundred and twenty-six patients aged≥13 years were diagnosed with scrub typhus.Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment(SOFA)score on admission.Results:About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt.Fever(99.21%)and dyspnea(79.36%)were the most frequent complaints.Respiratory failure(81.75%)was the most common organ failure,followed by hepatic(52.38%),coagulative(47.62%),circulatory(33.33%),renal(21.43%),and cerebral dysfunction(13.49%).The median(Q1,Q3)SOFA score was 8(6,9),and 48.41%of the patients had a quick-SOFA score≥2.Organ supports with invasive ventilation(40.48%),vasopressors(36.51%),and renal replacement therapy(7.14%)were frequently required.The in-hospital mortality was 11.90% and was independently predicted by circulatory and hepatic failures on multivariate logistic regression(OR 11.12,95%CI 1.73-71.31 and OR 8.49,95%CI 1.18-61.41,respectively).Conclusions:Most patients had pulmonary dysfunction;circulatory or hepatic failure on admission strongly predicts death. 展开更多
关键词 scrub typhus Orientia tsutsugamushi Organ failure MORTALITY PROGNOSIS
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Massive small bowel bleeding caused by scrub typhus in Korea 被引量:1
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作者 Ki Beom Bae Won Hwa Youn +2 位作者 Youn Jae Lee Soo Jin Jung Kwan Hee Hong 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2010年第2期47-50,共4页
A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple sm... A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy.Despite intensive therapy,the massive hematochezia worsened and the distal small bowel was resected.Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus.This is the first reported case of pathologically proven small bowel involvement in scrub typhus infection. 展开更多
关键词 HEMATOCHEZIA SMALL BOWEL BLEEDING scrub typhus Vasculitis Multiple SMALL BOWEL ULCERATIONS
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Spectrum of cardiac manifestations and its relationship to outcomes in patients admitted with scrub typhus infection 被引量:1
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作者 Gunasekaran Karthik Thomas Isaiah Sudarsan +6 位作者 John Victor Peter Thambu Sudarsanam George M Varghese Paul Kundavaram Sowmya Sathyendra Ramya Iyyadurai Kishore Pichamuthu 《World Journal of Critical Care Medicine》 2018年第1期16-23,共8页
AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes.METHODS Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and dia... AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes.METHODS Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio(OR) with 95%CI.RESULTS The cohort(n = 81; 35 males) aged 49.4 ± 16.1 years(mean, SD) presented 8.1 ± 3.1 d after symptom onset. The APACHE-Ⅱ score was 15.7 ± 7.0. Fortyeight (59%) patients were ventilated, and 46 (56%) required vasoactive agents. Mortality was 9.9%. ECG changes were non-specific; sinus tachycardia was the most common finding. Myocardial injury was evident in 61.7% of patients and LV systolic dysfunction in 30.9%. A diagnosis of myocarditis was made in 12.3%. In addition, seven patients with regional wall motion abnormalities had LV systolic dysfunction and elevated cardiac enzymes. Mild diastolic dysfunction was observed in 18 (22%) patients. Mild to moderate pericardial effusion was seen in 51%. On multivariate logistic regression analysis, patients with myocarditis tended to be older (OR = 1.04, 95%CI: 0.99-1.09), had shorter symptom duration (OR = 0.69, 95%CI: 0.49-0.98), and tended to stay longer in hospital(OR = 1.17, 95%CI: 0.98-1.40). Myocarditis was not associated with increased mortality.CONCLUSION In scrub typhus infection, cardiac manifestations are frequent and associated with increased morbidity but not mortality. 展开更多
关键词 scrub typhus MYOCARDITIS OUTCOME
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Neglected scrub typhus:An updated review with a focus on omics technologies
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作者 Dixit Sharma Ankita Sharma +2 位作者 Birbal Singh Sunil Kumar Shailender Kumar Verma 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2022年第12期531-541,共11页
Scrub typhus is a neglected disease and one of the most serious health problems in the Asia-Pacific region.The disease is caused by an obligate intracellular bacteria Orientia tsutsugamushi,which is transmitted by chi... Scrub typhus is a neglected disease and one of the most serious health problems in the Asia-Pacific region.The disease is caused by an obligate intracellular bacteria Orientia tsutsugamushi,which is transmitted by chigger bites or larval mite bites.Scrub typhus is a threat to billions of people worldwide causing different health complications and acute encephalitis in infants and growing children.The disease causes multiple organ failure and mortality rates may reach up to 70%due to a lack of appropriate healthcare.Currently available genome and proteome databases,and bioinformatics methods are valuable tools to develop novel therapeutics to curb the pathogen.This review discusses the state-of-the-art of information about Orientia tsutsugamushi-mediated scrub typhus and delineates the role of omics technologies to develop drugs against the pathogen.The role of proteome-wide in silico approaches for the identification of therapeutic targets is also highlighted. 展开更多
关键词 Orientia tsutsugamushi scrub typhus Therapeutic targets Omics technologies Drug discovery
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Manifestation of acute peritonitis and pneumonedema in scrub typhus without eschar:A case report
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作者 Xiu-Ling Zhou Qing-Long Ye +2 位作者 Jia-Qian Chen Wei Li Hao-Jian Dong 《World Journal of Clinical Cases》 SCIE 2021年第23期6900-6906,共7页
BACKGROUND Scrub typhus is an acute infectious disease caused by rickettsia infection.The diagnosis is based on eschar,and clinical manifestations can range from asymptomatic to multiorgan dysfunction.CASE SUMMARY We ... BACKGROUND Scrub typhus is an acute infectious disease caused by rickettsia infection.The diagnosis is based on eschar,and clinical manifestations can range from asymptomatic to multiorgan dysfunction.CASE SUMMARY We report the case of a 35-year-old man living in Zhuhai,Guangdong,China,who had repeated high fever with a maximum body temperature of 40.2°C and elevated white blood cells and procalcitonin levels.After 7 d of persistent high fever,the patient developed rash,abdominal pain,and symptoms of peritonitis.Within 24 h after admission,the patient developed diffuse peritonitis and pneumonedema,requiring ventilator support in the intensive care unit.However,there was no eschar on the body,and the first Weil-Felix test was negative.Taking into account that the patient had a history of jungle activities,doxycycline combined with meropenem was selected.The patient improved,healed,and was discharged after a week.The diagnosis of scrub typhus was confirmed by a repeat Weil-Felix test(Oxk 1:640),and pathology of the appendix resected by laparotomy suggests vasculitis.CONCLUSION This rare presentation of peritonitis,pulmonary edema,and pancreatitis caused by scrub typhus reminds physicians to be alert to the possibility of scrub typhus. 展开更多
关键词 scrub typhus PERITONITIS Pneumonedema Pancreatitis MYOCARDITIS VASCULITIS Case report
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Association between scrub typhus encephalitis and diffusion tensor tractography detection of Papez circuit injury:A case report
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作者 Hyeok Gyu Kwon Jeong-Hee Yang +1 位作者 Jee-Hyun Kwon Dongseok Yang 《World Journal of Clinical Cases》 SCIE 2021年第13期3194-3199,共6页
BACKGROUND It is difficult to restore the cognitive functions of patients with impaired cognition caused by brain injury.Diffusion tensor imaging can visualize the integrity of neural tracts in the white matter(WM)thr... BACKGROUND It is difficult to restore the cognitive functions of patients with impaired cognition caused by brain injury.Diffusion tensor imaging can visualize the integrity of neural tracts in the white matter(WM)three-dimensionally.It is unclear whether encephalitis following scrub typhus damages the WM.For the first time,we aimed to report diffusion tensor tractography(DTT)findings in a chronic patient with cognitive impairment following scrub typhus encephalitis,which revealed injury to the Papez circuit of the WM.CASE SUMMARY A 70-year-old male patient was affected by encephalitis caused by scrub typhus that occurred 23 years ago.He had poor cognition and his clinical examination findings were as follows:Mini-Mental Status Examination score,14;and handgrip strength(right/left,kg),32.3/31.3.DTT revealed serious injuries of the left thalamocingulate tract and right mammillothalamic tract in the Papez circuit,and a partial injury of the anterior part of the fornix.CONCLUSION Using DTT,we found a relationship between cognitive impairment and the integrity of the Papez circuit following scrub typhus. 展开更多
关键词 Diffusion tensor imaging scrub typhus ENCEPHALITIS White matter Papez circuit COGNITION Case report
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In Search of Scrub Typhus: A Prospective Analysis of Clinical and Epidemiological Profile of Patients from a Tertiary Care Hospital in New Delhi
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作者 Nitin Gupta Rama Chaudhry +5 位作者 Sushil K. Kabra Rakesh Lodha Bijay R. Mirdha Bimal K. Das Naveet Wig Vishnubhatla Sreenivas 《Advances in Infectious Diseases》 2015年第4期140-147,共8页
Introduction: Scrub typhus is a febrile illness caused by Orientia tsutsugamushi which is transmitted by the larval stage of trombiculid mites. It has varied manifestations ranging from mild disease to fatal illness. ... Introduction: Scrub typhus is a febrile illness caused by Orientia tsutsugamushi which is transmitted by the larval stage of trombiculid mites. It has varied manifestations ranging from mild disease to fatal illness. The classical manifestations include fever, rash, lymphadenopathy and eschar. Serology is the preferred diagnostic tool with indirect immunofluorescence assay (IFA) as the current gold standard. Material & Methods: A total of 229 clinically suspected cases of Scrub typhus from 15th of October 2013 to 15th of October 2015 were enrolled in the study. Clinical, epidemiological and laboratory data of the patients were collected and analysed. The method for diagnosis was IgM immunofluorescence assay. Results: A total of 33 cases (14.4%) of scrub typhus were detected. Most of the cases (87%) presented in the months of September to November. Fever of >39°C was seen in all 33 cases. Rash and eschar were seen in 24.2% and 18.2% cases, respectively. Lymphadenopathy (18.2%), hepatomegaly (48.5%), splenomegaly (21.2%) and icterus (15.2%) were seen in some cases. Pulmonary manifestations were noted in 69.7% of cases. Acute kidney injury (18.2%), encephalitis (21.2%), and myocarditis (15.15%) were the other complications observed. Common haematological abnormalities noted in patients of scrub typhus were anaemia (45.6%), leucocytosis (45.6%), thrombocytopenia (48.5%) and transaminitis (54.5%). 10 cases were treated by azithromycin while doxycycline was used for treatment in 28 cases. Conclusion: The nonspecific symptoms and lack of classical manifestations make the diagnosis of scrub typhus difficult. There is a definite need to increase awareness and heighten the suspicion, especially in the light of increasing number of patients presenting with atypical manifestations. 展开更多
关键词 scrub typhus India EPIDEMIOLOGY
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A Case Report of Scrub Typhus: Secondary Acute Arrest of Hemopoiesis with Multiple Organ Dysfunction Syndromes
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作者 Guancheng Song Ying Song +2 位作者 Yanfang Zhang Xi Huang Jianchuan Deng 《Open Journal of Blood Diseases》 CAS 2022年第3期53-59,共7页
Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi (O. tsutsugamushi) in which humans are accidental hosts. Acute arrest of hemopoiesis (AAH) always manifests in pancytopenia and with supportive treat... Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi (O. tsutsugamushi) in which humans are accidental hosts. Acute arrest of hemopoiesis (AAH) always manifests in pancytopenia and with supportive treatment or inducement removal, the AAH patients would show significant improvement in blood routine for about a week. As a rapidly progressive and potentially life-threatening organ function disorder syndrome, multiple organ dysfunction syndrome (MODS) is often induced by many factors including infection, illness and injury. We received a rare case of scrub typhus rapidly presenting with AAH and MODS 2 weeks ago. The clinical data of a 32-year-old female with O. tsutsugamushi-induced AAH and MODS was summarized retrospectively and analyzed with a literature review. In this case, we selected tigecycline and moxifloxacin as treatment regimens for scrub typhus. When the potential infection was controlled, her pancytopenia and hepatic function rapidly improved in a few days. 展开更多
关键词 scrub typhus Orientia tsutsugamushi Acute Arrest of Hemopoiesis Multiple Organ Dysfunction Syndrome
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Spontaneous splenic rupture associated with scrub typhus: a case report
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作者 Hong Pil Hwang Kyoung Min Kim +1 位作者 Hyojin Han Jeong-Hwan Hwang 《Infectious Diseases of Poverty》 SCIE CAS CSCD 2024年第1期97-97,共1页
Background Scrub typhus,an acute febrile disease with mild to severe,life-threatening manifestations,potentially presents with a variety of complications,including pneumonia,acute respiratory distress syndrome,cardiac... Background Scrub typhus,an acute febrile disease with mild to severe,life-threatening manifestations,potentially presents with a variety of complications,including pneumonia,acute respiratory distress syndrome,cardiac arrhyth-mias(such as atrial fibrillation),myocarditis,shock,peptic ulcer,gastrointestinal bleeding,meningitis,encephalitis,and renal failure.Of the various complications associated with scrub typhus,splenic rupture has rarely been reported,and its mechanisms are unknown.This study reports a case of scrub typhus-related spontaneous splenic rupture and identifies possible mechanisms through the gross and histopathologic findings.Case presentation A 78-year-old man presented to our emergency room with a 5-day history of fever and skin rash.On physical examination,eschar was observed on the left upper abdominal quadrant.The abdomen was not ten-der,and there was no history of trauma.The Orientia tsutsugamushi antibody titer using the indirect immunofluo-rescent antibody test was 1:640.On Day 6 of hospitalization,he complained of sudden-onset left upper abdominal quadrant pain and showed mental changes.His vital signs were a blood pressure of 70/40 mmHg,a heart rate pf 140 beats per min,and a respiratory rate of 20 breaths per min,with a temperature of 36.8℃.There were no signs of gastrointestinal bleeding,such as hematemesis,melena,or hematochezia.Grey Turner's sign was suspected during an abdominal examination.Portable ultrasonography showed retroperitoneal bleeding,so an emergency exploratory laparotomy was performed,leading to a diagnosis of hemoperitoneum due to splenic rupture and a sple-nectomy.The patient had been taking oral doxycycline(1o0 mg twice daily)for 6 days;after surgery,this was dis-continued,and intravenous azithromycin(500 mg daily)was administered.No arrhythmia associated with azithro-mycin was observed.However,renal failure with hemodialysis,persistent hyperbilirubinemia,and multiorgan failure occurred.The patient did not recover and died on the fifty-sixth day of hospitalization.Conclusions Clinicians should consider the possibility of splenic rupture in patients with scrub typhus who display sudden-onset abdominal pain and unstable vital signs.In addition,splenic capsular rupture and extra-capsular hem-orrhage are thought to be caused by splenomegaly and capsular distention resulting from red blood cell congestion in the red pulp destroying the splenic sinus. 展开更多
关键词 scrub typhus COMPLICATION Splenic rupture
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Omadacycline in the treatment of scrub typhus:Three case reports
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作者 Xue-Mei Lang Yun Qiu +3 位作者 Ya-Juan Jia Hong Sun Su-Min Gao Hong-Mei Zhao 《World Journal of Clinical Cases》 SCIE 2024年第25期5832-5838,共7页
BACKGROUND Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi(O.tsutsugamushi).Omadacycline,a ... BACKGROUND Scrub typhus is a naturally occurring acute infectious disease that is primarily transmitted through the bites of chiggers or larval mites infected by Orientia tsutsugamushi(O.tsutsugamushi).Omadacycline,a novel tetracycline,exhibits potent antibacterial efficacy against both typical bacteria and atypical pathogens.However,omadacycline application in the treatment of scrub typhus remains limited.CASE SUMMARY In the present work,we report several cases of scrub typhus,with the main clinical symptoms being fever,the formation of eschars or ulcers,local or systemic lymphadenopathy,headache,myalgia and rash.Blood samples were collected before omadacycline was administered,and O.tsutsugamushi infection was confirmed through targeted next-generation sequencing(tNGS).After two days of treatment,the patients’symptoms,including fever,were alleviated,with no adverse drug reactions.CONCLUSION tNGS is an effective method for diagnosing scrub typhus.Omadacycline can be considered an alternative option for antiinfective therapy in patients with O.tsutsugamushi infections. 展开更多
关键词 Omadacycline scrub typhus Orientia tsutsugamushi Targeted nextgeneration sequencing Eschar Case report
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Molecular epidemic survey on co-prevalence of scrub typhus and marine typhus in Yuxi city,Yunnan province of China 被引量:18
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作者 ZHANG Li-juan LI Xue-mei +4 位作者 ZHANG De-rong ZHANG Jing-shan DI Ying LUAN Ming-chun FU Xiu-ping 《Chinese Medical Journal》 SCIE CAS CSCD 2007年第15期1314-1318,共5页
Background Human rickettsioses are worldwide zoonoses and it is not easy to differentiate them from other infectious diseases because of their atypical manifestation. In recent years the number of patients with fever ... Background Human rickettsioses are worldwide zoonoses and it is not easy to differentiate them from other infectious diseases because of their atypical manifestation. In recent years the number of patients with fever of unknown causes from Hongta District CDC, Yuxi city of Yunnan Province has been increasing significantly in the summer. Diagnosis of scrub typhus was made by local clinicians. In order to ascertain the disease, we undertook a laboratory investigation for such patients from August 18 to 26, 2005. Methods Active surveillance was conducted by Hongta District CDC Yuxi city of Yunnan Province from 2002 to 2004 and basic data were obtained from cases confirmed according to clinical definitions. Average incidences and town-level incidences were calculated during the study periods. Blood samples were analyzed by PCR and serological test. Based on the groEL gene sequences a paired general outer primers (Gro-1 and Gro-2) targeting typhus, spotted fever as well as scrub typhus and two paired inner primers (SF1, SR2 and TF1, TR2) for typhus together with spotted fever and scrub typhus, respectively, were designed to perform a multiplex-nested PCR. Serological assay was carried out by indirect immunofluorescence assay with 7 different rickettsial antigens, i.e., R.mossori, R.sibirica, R.conorii, O.tsutsugamushi, B.quintana, B.henselae and Coxilella burnetii phase Ⅱ Ag. Results Epidemiological surveillance showed that from 2002 to 2004, the average incidences of the scrub typhus or scrub typhus with murine typhus were 222.1/10^5, 204.3/10^5 and 109.6/10^5, respectively. Of 13 blood samples taken during acute stage of illness, 6 showed the amplified products for scrub typhus and the sequenced products showed 100%, 99%, 99%, 99%, 99%, 99% similarity to O.tsutsugamushi Karp but they shared the same deduced amino acid sequences, which indicated 100% identity with the heat shock protein of the O.tsutsugamushi Karp strain. Five yielded PCR products for murine typhus and their corresponding nucleotide sequences exhibited 100%, 100%, 99%, 99% and 99% similarity to R. mossori Wilmington and the analyses of predicted amino acid sequences indicated 100%, 100%, 98%, 98% and 98% identity with the heat shock protein of R. mossoriWilmington strain. Of the 8 PCR positive patients, 3 showed a co-infection of scrub typhus with murine typhus. All the 13 serum samples from febrile patients were positive against O. tsutsugamushi and 8 of them were positive against R. mossori. All of the 8 paired specimens had four-fold elevation of antibody against O. tsutsugamushi, and seroconversion for typhus was demonstrated in 3 paired serum samples. Another finding in the study was that a high seropositive prevalence (76.9%) of Q fever was detected. Concluaion It's confirmed that co-prevalence of scrub typhus with murine typhus are occurring in Yuxi city of Yunnan province, China. Other rickettsial diseases also need to be investigated in these areas. 展开更多
关键词 scrub typhus murine typhus Q fever PREVALENCE Yuxi
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Evaluation of scrub typhus diagnosis in China:analysis of nationwide surveillance data from 2006 to 2016 被引量:13
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作者 Hua-Lei Xin Jian-Xing Yu +7 位作者 Mao-Gui Hu Fa-Chun Jiang Xiao-Jing Li Li-Ping Wang Ji-Lei Huang Jin-Feng Wang Jun-Ling Sun Zhong-Jie Li 《Infectious Diseases of Poverty》 SCIE 2019年第3期105-105,共1页
Background:Scrub typhus is a life-threatening disease caused by O rientia tsu tsu gom u sh i,and specific antimicrobial medicine is available.Early and accurate diagnosis is essential for reducing the risk of severe c... Background:Scrub typhus is a life-threatening disease caused by O rientia tsu tsu gom u sh i,and specific antimicrobial medicine is available.Early and accurate diagnosis is essential for reducing the risk of severe complications and death.In this study,we aimed to evaluate the case diagnosis situation among medical care institutions and geographical regions in China,and the results will benefit both clinical practice and the disease surveillance system.Methods:We extracted individual scrub typhus case data 2006-2016 from a national disease surveillance system in China.The diagnosis category and interval time from illness onset to diagnosis were compared among three levels of medical care institutions and provinces.The descriptive analysis method was performed in our study.Results:During the 11-year study period,93481 scrub typhus cases,including 57 deaths,were recorded in the nationwide surveillance system.The overall proportion of laboratory-confirmed cases was only 4.7%,and this proportion varied greatly among primary medical centres(2.8%),county level hospitals(4.2%),and city level hospitals(6.3%).Notably,the proportion of laboratory-confirmed cases has consistently decreased from 16.3%in 2006 to 2.6%in 2016,and the same decreasing trend was found among all three levels of medical care institutions.The interval from illness onset to case diagnosis(Tdiag)for all cases was 5 days(interquartile range[IQR]:2-9 days)and decreased from 7 days(IQR:3-11 days)in 2006 to 5 days(IQR:2-8 days)in 2016.The risk of death for patients with a Tdiag of>7 days was 2.2 times higher(OR=22),(95%CI:1.05-5.21)than that of patients with a Tdiag of<2 days.Conclusions:The interval time from illness onset to diagnosis for scrub typhus cases decreased greatly in China;however,the diagnosis rate of cases with laboratory-confirmed results must be increased among all levels of medical care institutions to reduce both the risk of death and the misuse of antibiotics associated with scrub typhus. 展开更多
关键词 scrub typhus DIAGNOSIS EVALUATION China
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Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India 被引量:6
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作者 Sunuraj Sivarajan Siddharudha Shivalli +2 位作者 Debomallya Bhuyan Michael Mawlong Rittwick Barman 《Infectious Diseases of Poverty》 SCIE 2016年第1期825-834,共10页
Background:India is an integral component of“tsutsugamushi triangle”which depicts a part of the globe endemic to scrub typhus.Owing to frequent outbreaks witnessed in different parts of the country in the recent pas... Background:India is an integral component of“tsutsugamushi triangle”which depicts a part of the globe endemic to scrub typhus.Owing to frequent outbreaks witnessed in different parts of the country in the recent past,scrub typhus is described as a re-emerging infectious disease in India.The present study aimed to study the clinical and paraclinical profile,complications and predictors of outcome among 90 cases of scrub typhus diagnosed in a hospital of north-eastern India from Sept 2011 to Aug 2012.Methods:A longitudinal study was conducted in a hospital of Meghalaya,India between Sept 2011 and Aug 2012.Diagnosis of scrub typhus was arrived by SD BIOLINE tsutsugamushi(solid phase immunochromatographic assay)rapid diagnostic test for antibodies(IgM,IgG or IgA).Descriptive analyses of age,gender,geographic area,symptoms and signs,treatment,laboratory findings,complications,and outcome were conducted.Relative risk(RR)with 95%confidence interval(CI)was computed for Multiple Organ Dysfunction Syndrome(MODS)and mortality.Binary logistic regression was applied to the significant correlates(P<0.05)on univariate analysis to identify the predictors of MODS and mortality in scrub typhus.Results:As many as 662 clinically suspected scrub typhus patients were tested and 90(13.6%)were diagnosed to have scrub typhus.Out of 90 patients,52.2%(n=47)were males and their mean(SD)age was 36.29(13.38)years.Fever of<7 days(n=75,83.3%),myalgia(n=56,62.2%),pain abdomen(n=24,26.7%),headache(n=24,26.7%),nausea/vomiting(n=21,23.3%),dry cough(n=21,23.3%),hepatomegaly(n=24,26.7%),splenomegaly(n=22,24.4%),and lymphadenopathy(n=20,22.2%)were the predominant clinical features.Eschar was seen in 10 patients(11.1%).One third(n=30)of the patients developed at least one systemic complication.Acute hepatitis(n=15,16.7%),pneumonitis(n=14,15.6%),and acute kidney injury(n=11,12.2%)were the common complications.MODS was seen in 14.4%(n=13)and 38.5%(n=5)of the patients with MODS died.Overall,case fatality rate was 5.15%(n=5).On univariate analysis,platelets<100000/mm3,serum creatinine>1.5 mg/dl,and transaminase(AST,ALT or both)>500 U/L were associated with MODS(P<0.001)and mortality(P<0.05).In addition,serum bilirubin>3 mg/dl was also associated with MODS(P<0.001).On applying binary logistic regression,serum creatinine>1.5 mg/dl was a predictor of MODS(OR:76.1,95%CI:4.9–1175.6)and mortality(OR:18.03,95%CI:1.38–235.1).Conclusion:In this study setting,approximately one-seventh(13.6%)of the acute undifferentiated febrile illness were due to scrub typhus.Systemic complications were common(33.3%).Serum creatinine>1.5 mg/dl was a predictor of MODS and mortality. 展开更多
关键词 HOSPITAL INDIA Longitudinal Multiple Organ Dysfunction Syndrome(MODS) MORTALITY scrub typhus
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重新认识氯霉素对小儿恙虫病的临床作用 被引量:6
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作者 冯娟 植旭丽 赖丹娜 《中国实用医药》 2013年第17期54-55,共2页
目的重新认识氯霉素对小儿恙虫病的临床作用。方法对近5年收治的153例小儿恙虫病分成不伴多器官功能损害组和伴多器官功能损害组,应用氯霉素和阿奇霉素治疗,进行临床分析。结果不伴多器官功能损害组,氯霉素和阿奇霉素疗效无差异;伴多器... 目的重新认识氯霉素对小儿恙虫病的临床作用。方法对近5年收治的153例小儿恙虫病分成不伴多器官功能损害组和伴多器官功能损害组,应用氯霉素和阿奇霉素治疗,进行临床分析。结果不伴多器官功能损害组,氯霉素和阿奇霉素疗效无差异;伴多器官功能损害组,氯霉素较阿奇霉素效果显著。差异有统计学意义。结论轻症病例,可首选大环内酯类抗生素,如阿奇霉素治疗,如患儿并多器官功能损害,则应果断应用氯霉素以达到迅速起效,以免延误治疗,导致病情加重或出现更多的并发症,错过治疗机会。传统药物氯霉素在小儿恙虫病的治疗中仍处在不可被替代的地位。 展开更多
关键词 Recognizing Chloromycetin CHILDREN scrub typhus
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