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Case Reports
. 2023 Nov;51(11):3000605231214503.
doi: 10.1177/03000605231214503.

Clinical treatment of patients with scrub typhus-induced liver injury and intracranial infection

HongKui Sun  1 , Li Lei  2 , JianWei Li  1 , Haiming Niu  1 , Jiezhang Yang  1 , MiaoLian Chen  1
Affiliations
Case Reports

Clinical treatment of patients with scrub typhus-induced liver injury and intracranial infection

HongKui Sun et al. J Int Med Res. 2023 Nov.

Abstract

Scrub typhus is an infectious disease caused by Orientia tsutsugamushi, a bacterium within the family Rickettsiaceae. The clinical symptoms are usually acute and are characterized by fever, eschar formation or ulceration, local or generalized lymphadenopathy, and rash. Because of the extensive damage to small blood vessels throughout the body, scrub typhus can involve multiple systems and organs, causing damage to the respiratory, digestive, and nervous systems and inducing kidney and liver dysfunction. Death can occur in severe cases. We herein report two cases of scrub typhus with liver damage and intracranial infection. Among patients with scrub typhus, the risk of death is significantly higher in those who develop liver injury and intracranial infection. However, there are few reports on the treatment of patients with liver injury and intracranial infection caused by scrub typhus, and relevant treatment experience is thus lacking. Our clinical case report helps to fill the knowledge gap in this area.

Keywords: Eschar; intracranial infection; liver injury; metagenomic next-generation sequencing; multiple organ dysfunction; scrub typhus.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Right axillary skin lesion, 0.8 × 0.6 cm (Case 1).
Figure 2.
Figure 2.
Circular black scab with a diameter of approximately 1 cm on the right scrotum (Case 2).
Figure 3.
Figure 3.
Brain magnetic resonance imaging results on day 10 of hospitalization (Case 2)
See this image and copyright information in PMC

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References

    1. Luo L, Guo Z, Lei Z, et al.. Epidemiology of tsutsugamushi disease and its relationship with meteorological factors in Xiamen city, China. PLoS Negl Trop Dis 2020; 14: E0008772. doi: 10.1371/journal.pntd.0008772. PMID: 33057334; PMCID: PMC7591240. - PMC - PubMed
    1. Bahk YY, Jun H, Park SH, et al.. Surveillance of chigger mite vectors for Tsutsugamushi disease in the Hwaseong area, Gyeonggi-do, Republic of Korea, 2015. Korean J Parasitol 2020; 58: 301–308. doi: 10.3347/kjp.2020.58.3.301. Epub 2020 Jun 26. PMID: 32615743; PMCID: PMC7338901. - PMC - PubMed
    1. Banerjee A, Kulkarni S. Orientia tsutsugamushi: the dangerous yet neglected foe from the East. Int J Med Microbiol 2021; 311: 151467. doi: 10.1016/j.ijmm.2020.151467; PMID: 33338890. - PubMed
    1. Fujiwara S, Shimizu T. A typical case of scrub typhus (tsutsugamushi disease). BMJ Case Rep 2014; 2014: bcr2014207824. doi: 10.1136/bcr-2014-207824; PMID: 25355755; PMCID: PMC4216889. - PMC - PubMed
    1. Paris DH, Shelite TR, Day NP, et al.. Unresolved problems related to scrub typhus: a seriously neglected life-threatening disease. Am J Trop Med Hyg 2013; 89: 301–307. doi: 10.4269/ajtmh.13-0064. PMID: 23926142; PMCID: PMC3741252. - PMC - PubMed

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