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Case Reports
. 2021 Jul 22;16(9):2754-2756.
doi: 10.1016/j.radcr.2021.06.066. eCollection 2021 Sep.

Xerostomia in a patient with scrub typhus

Yeon-Hee Han  1 , Joo-Hee Hwang  2 , Chang-Seop Lee  2
Affiliations
Case Reports

Xerostomia in a patient with scrub typhus

Yeon-Hee Han et al. Radiol Case Rep. .

Erratum in

Abstract

Scrub typhus is an acute febrile disease caused by the intracellular organism Orientia tsutsugamushi. The main pathogenesis is focal or disseminated multi-organ vasculitis caused by the infection of endothelial cells and the perivascular infiltration of leukocytes. Many studies have reported interstitial pneumonia, cholecystitis, pancreatitis, and meningoencephalitis in scrub typhus. However, there is no report about sialoadenitis in a patient with scrub typhus. A 79-year-old man was admitted to the emergency room due to a high fever, headache, and myalgia. Scrub typhus was confirmed based on the indirect immunofluorescence assay and the nested polymerase chain reaction. He suffered from severe dry mouth and underwent Tc-99m pertechnetate salivary scintigraphy. While the radiopharmeceutical uptake of the bilateral parotid and submandibular glands was within normal range, salivary excretion into the oral cavity was markedly decreased. After the proper antibiotic treatment, salivary scintigraphy was performed again. Radioactivity in the oral cavity was increased and the ejection fraction (%) after using sialogogue was also improved to the normal range. As far as we know, this is the first report to show salivary scintigraphy of a patient with scrub typhus. By using a Tc-99m pertechnetate salivary scintigraphy, we found that the excretory function of salivary glands was markedly decreased, while the uptake ability was preserved in scrub typhus, unlike Sjögren's syndrome and radiation-induced xerostomia. Salivary scintigraphy presents dry mouth objectively and provides quantitative values as well. Salivary scintigraphy could contribute to the assessment of sialoadenitis before and after treatment of scrub typhus.

Keywords: Salivary scintigraphy; Scrub typhus; Xerostomia.

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Figures

Fig.1–
Fig. 1
On pre-treatment imaging (A), salivary excretion into the oral cavity was markedly decreased 40 minutes after radiotracer injection (arrow). After antibiotic treatment (B), radioactivity in the oral cavity was increased to normal range (open arrow).
Fig. 2–
Fig. 2
Ejection fraction (%) was measured after administration of sialogogue (orange juice, 200 mL). It increased from 49%– 58% (A) to 63% – 72% (B).
See this image and copyright information in PMC

References

    1. Tamura A, Ohashi N, Urakami H, Miyamura S. Classification of rickettsia tsutsugamushi in a new genus, Orientia gen. nov., as Orientia tsutsugamushi comb. nov. Int J Syst Bacteriol. 1995;45:589–591. - PubMed
    1. Paris DH, Phetsouvanh R, Tanganuchitcharnchai A, Jones M, Jenjaroen K, Vongsouvath M. Orientia tsutsugamushi in human scrub typhus eschars shows tropism for dendritic cells and monocytes rather than endothelium. PLoS Negl Trop Dis. 2012;6:e1466. - PMC - PubMed
    1. Tantibhedhyangkul W, Ben Amara A, Textoris J, Gorvel L, Ghigo E, Capo C. Orientia tsutsugamushi, the causative agent of scrub typhus, induces an inflammatory program in human macrophages. Microb Pathog. 2013;55:55–63. - PubMed
    1. Choi JH, Cheong TC, Ha NY, Ko Y, Cho CH, Jeon JH. Orientia tsutsugamushi subverts dendritic cell functions by escaping from autophagy and impairing their migration. PLoS Negl Trop Dis. 2013;7:e1981. - PMC - PubMed
    1. Murata M, Sudo K, Suzuki K, Aoyama Y, Nogami S, Tanaka H. Proliferating sites of rickettsia tsutsugamushi in mice by different routes of inoculation evidenced with immunofluorescence. Jpn J Exp Med. 1985;55:193–199. - PubMed

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