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Case of scrub typhus complicated by severe disseminated intravascular coagulation and death
Author(s) -
Ono Yuko,
Ikegami Yukihiro,
Tasaki Kazuhiro,
Abe Masahumi,
Tase Choichiro
Publication year - 2012
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2012.01600.x
Subject(s) - medicine , disseminated intravascular coagulation , scrub typhus , typhus , intensive care medicine , pathology , virology
Abstract Scrub typhus is an infectious disease that is caused by O rientia tsutsugamushi . The authors describe an autopsied case of scrub typhus complicated with severe disseminated intravascular coagulation ( DIC) . An 82‐year‐old man complained of fever 4 days after climbing a mountain. The patient was admitted to an urban hospital, and meropenem and ceftriaxone were administered. The patient's condition deteriorated and he was transferred to a second hospital. On physical examination, a black scab was found and scrub typhus was suspected. Despite intensive treatment, the patient died on the fifth day. High levels of O . tsutsugamushi IgM antibody were confirmed. An autopsy revealed systemic vasculitis and perivasculitis. The endothelial tissue of the white pulp of the spleen was markedly infiltrated by plasma cells. The authors speculated that a severe immune reaction against O . tsutsugamushi enhanced an inflammatory response, leading to DIC . This case is a warning to doctors who are not familiar with scrub typhus.