Scrub typhus (Tsutsugamushi disease) in a patient presenting with hemophagocytic syndrome.

Authors:
Tomoyuki Mukai
Tomoyuki Mukai
School of Dentistry
Shoko Tsuji
Shoko Tsuji
Kansai Medical University
Japan
Yoshitaka Morita
Yoshitaka Morita
Kawasaki Medical School
Japan

Immunol Med 2018 Jun 17;41(2):82-84. Epub 2018 Aug 17.

a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan.

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which is found mainly in East and Southeast Asia and in Australia. The disease presents with a variety of non-specific symptoms, including fever, headache, cough, myalgia, and rash. Delay in starting appropriate antimicrobial therapy may lead to serious complications and even death. We report the case of an 84-year-old Japanese patient with scrub typhus who developed hemophagocytic syndrome (HPS) and was successfully treated with minocycline in addition to corticosteroids. A pathognomonic skin ulcer on her right buttock, which was initially covered with black eschar, prompted us to consider the possibility of scrub typhus. Blood polymerase chain reaction and antibody assays confirmed the diagnosis. Scrub typhus must be considered as one of the underlying diseases that may cause HPS in patients living in the Asia-Pacific region and in those who have recently returned from endemic areas.

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Source
http://dx.doi.org/10.1080/13497413.2018.1481581DOI Listing
June 2018
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References

(Supplied by CrossRef)
Article in J Assoc Physicians India
Pragna GS et al.
J Assoc Physicians India 2016

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