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Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/414

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Title: A case of scrub typhus complicated by severe DIC and death
Other Titles: Case of scrub typhus complicated by severe disseminated intravascular coagulation and death
Authors: Ono, Yuko
Ikegami, Yukihiro
Tasaki, Kazuhiro
Abe, Masahumi
Tase, Choichiro
Affiliation: 救急医療学講座
Source title: Emergency medicine Australasia
Volume: 24
Issue: 5
Start page: 577
End page: 580
Issue Date: Oct-2012
Abstract: Scrub typhus is an infectious disease that is caused by Orientia 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.
Publisher: Wiley
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/414
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/414/1/EmergMedAustralas_24_p577.pdf
ISSN: 1742-6723
DOI: 10.1111/j.1742-6723.2012.01600.x
PubMed ID: 23039302
Other version: http://dx.doi.org/10.1111/j.1742-6723.2012.01600.x
Rights: © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. This is the peer reviewed version of the following article: Emerg Med Australas. 24(5):577-80, which has been published in final form at http://dx.doi.org/10.1111/j.1742-6723.2012.01600.x
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