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Case Reports
. 2015 Jan;92(1):145-7.
doi: 10.4269/ajtmh.14-0478. Epub 2014 Nov 10.

Neuritis and gastrointestinal hemorrhage in scrub typhus patients

Dong-Min Kim  1 , Na Ra Yun  1 , Sung-Chul Lim  2
Affiliations
Case Reports

Neuritis and gastrointestinal hemorrhage in scrub typhus patients

Dong-Min Kim et al. Am J Trop Med Hyg. 2015 Jan.

Abstract

A 78-year-old woman with scrub typhus exhibited gastric hemorrhage with multiple gastric ulcers. This is the first report to confirm pathologically the presence of not only vasculitis but also, neuritis. The results suggest the necessity of studies confirming neuritis as the cause of gastric ulcer and bleeding in scrub typhus.

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Figures

Figure 1.
Figure 1.
(A) Endoscopic findings subsequent to melena in a 78-year-old woman with scrub typhus revealing observations of multiple ulcerative craters in the lesser and greater curvatures of the stomach. (B) Gross pathology of the stomach after the emergency total gastrectomy was performed because of hemorrhage caused by melena on the fifth day of the patient's admission. There were multiple mucosal ulcerations (white arrows) and linear or oval mucosal erosions (black arrows). (C) Histopathological findings of gastric ulcer in the scrub typhus patient. Acute inflammatory cell infiltration in the vascular wall (arrows) was noted. Fibrin thrombi (Inset) were found frequently. H&E staining. (D) Histopathological findings of gastric ulcer in the scrub typhus patient. Acute and chronic inflammatory cell infiltration in the myenteric nerve bundle (arrows). H&E staining.
See this image and copyright information in PMC

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