A case of scrub typhus with acute myelitis
Abstract
Abstract :
We describe a rare case of acute myelitis with scrub typhus. This acute febrile illness caused by orientia tsutsugamushi constitutes focal or disseminated vasculitis caused by the destruction of endothelial cells and the perivascular infiltration of leucocytes. The diagnosis of scrub typhus is based on the patients history of exposure, clinical features, and results of serologic testing. Our case indicates that Orientia tsutsugamushi can invade spinal cord. A high degree of clinical suspicion of scrub typhus allow early diagnosis and timely initiation of appropriate therapy, and thereby may help reduce patient morbidity and mortality.
Keyword :scrub typhus, eschar, acute renal failure, acute myelitis, paraplegia, interstitial pneumonia.
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David h. Walker, J. stephen dumler, Thomas Marrie-HARRISON`S principles of internal medicine18th edition. Chapter 174, Page 1413
Phongmany S, Rolain JM, Phetsouvanh R et al. Rickettsial infections and fever, Vientiane, Laos. Emerg Infect Dis 2006; 12:256-62.
Suttinont C, Losuwanaluk K, Niwatayakul K et al. Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study. Ann Trop Med Parasitol 2006;100:363- 70.
Watt G, Parola P. Scrub typhus and tropical rickettsioses. Curr Opin Infect Dis 2003; 16: 429-36.
Rakendra singh, Clinical Manifestations & Complications of Scrub typhus, http://www.jkscience.org/archive/volume122/.
Paris DH, Jenjaroen K, Blacksell SD et al. Differential patterns of endothelial and leucocyte activation in 'typhuslike' illnesses in Laos and Thailand. Clinical & Experimental Immunology 2008;153: 63-67
Khongphatthanayothin A, Phumaphuti P, Thongchaiprasit K, Poovorawan Y. Serum levels of sICAM-1 and sE-selectin in patients with dengue virus infection. Jpn J Infect Dis 2006; 59:186-88.
Turner GD, Ly VC, Nguyen TH et al. Systemic endothelial activation occurs in both mild and severe malaria. Correlating dermal microvascular endothelial cell phenotype and soluble cell adhesion molecules with disease severity. Am J Pathol 1998;152:1477-87.
Vitale G, Mansueto S, Gambino G et al. Differential upregulation of circulating soluble selectins and endothelial adhesion molecules in Sicilian patients with Boutonneuse fever. Clin Exp Immunol 1999; 117:304-08.
Lasky LA. Selectin-carbohydrate interactions and the initiation of the inflammatory response. Annu Rev Biochem 1995; 64:113-39.
Alon R, Chen S, Puri KD, Finger EB, Springer TA. The kinetics of 1-selectin tethers and the mechanics of selectinmediated rolling. J Cell Biol 1997; 138:1169-80.
Mathai E, Rolain JM, Verghese GM et al. Outbreak of Scrub Typhus in Southern India during the cooler months. Ann. New York Acad Sci. 2003; 990:359-64.
Somashekar HR, Moses PD, Pavithran S, et al. Magnitude and features of scrub typhus andspotted fever in children in India. J Trop Paediatr 2005;16.
Sharma A, Mahajan S, Gupta ML, et al. Investigation of an outbreak of Scrub Typhus in Himalayan region of India. Jpn J Infect Dis 2005; 58: 208-10.
Varghese GM, Abraham DC, Mathai D, Thomas K, Aaron R, KavitaML, et al. Scrub typhus among hospitalized patients with febrile illness in South India. Magnitude & Clinical Predictors. J Infect 2006; 52 : 56-60.
Lee KL et al, Acute transverse myelitis associated
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