장관염을 동반한 Ikeda표현형 중증 쯔쯔가무시병 1예
Severe Scrub Typhus with Enterocolitis by the Ikeda Strain of Orientia tsutsugamushi
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Scrub typhus is a mite-borne bacterial infection of humans that is caused by Orientia tsutsugamushi , which causes generalized vasculitis. The disease may involve the tissues of any organ system but no case with involvement of the lower gastrointestinal tract has been reported. We report a case of a 39-year old Korean male with enterocolitis of severe scrub typhus, of which the serotype was Ikeda strain. The patient was admitted to hospital with fever, abdominal pain and shock. He developed multi organ failure and frequent watery diarrhea. Abdominal computed tomography revealed diffuse edematous thickening of the entire small and colon with inflammation. Three days after admission, the antibody to O. tsutsugamushi was reported to be 1:320. He improved with doxycycline and azithromycin, and the persistent watery diarrhea stopped at 24 hours. This study shows that scrub typhus should be considered when the small and large intestine are affected. For the genotype of O. tsutsugamushi in Korea, additional studies of the impact of changes in the vector distribution on the genotype distribution will be needed.
Abstract
Scrub typhus is a mite-borne bacterial infection of humans that is caused by Orientia tsutsugamushi , which causes generalized vasculitis. The disease may involve the tissues of any organ system but no case with involvement of the lower gastrointestinal tract has been reported. We report a case of a 39-year old Korean male with enterocolitis of severe scrub typhus, of which the serotype was Ikeda strain. The patient was admitted to hospital with fever, abdominal pain and shock. He developed multi organ failure and frequent watery diarrhea. Abdominal computed tomography revealed diffuse edematous thickening of the entire small and colon with inflammation. Three days after admission, the antibody to O. tsutsugamushi was reported to be 1:320. He improved with doxycycline and azithromycin, and the persistent watery diarrhea stopped at 24 hours. This study shows that scrub typhus should be considered when the small and large intestine are affected. For the genotype of O. tsutsugamushi in Korea, additional studies of the impact of changes in the vector distribution on the genotype distribution will be needed.
참고문헌 (15)
- Ogawa M., "Scrub typhus in Japan : epidemiology and clinical features of cases reported in 1998", Am J Trop Med Hyg, 67, pp.162~165 (2002)
- Kim DM., "Clinical and laboratory findings associated with severe scrub typhus", BMC INFECTIOUS DISEASES, 10, pp.108~ (2010), BIOMED CENTRAL LTD
- Kim SJ., "The clinical significance of upper gastrointestinal endoscopy in gastrointestinal vasculitis related to scrub typhus", Endoscopy, 32, pp.950~955 (2000)
- Hwang JH., "Risk Factors Leading to Fatal Outcome in Scrub Typhus", JK Science, 12, pp.67~69 (2010)
- 김동민, "Phylogenetic Analysis of the 56 kDa Protein Genes of Orientia tsutsugamushi in Southwest Area of Korea", AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 84(2), pp.250~254, AMER SOC TROP MED HYGIENE
- 김동민, "쯔쯔가무시병의 임상 특징과 진단", Infection and Chemotherapy, 41(6), pp.315~322 (2009), 대한감염학회
- Lee N., "Risk factors associated with life-threatening rickettsial infections", Am J Trop Med Hyg, 78, pp.973~978 (2008)
- Balthazar EJ., "CT of the gastrointestinal tract : principles and interpretation", AJR Am J Roentgenol, 156, pp.23~32 (1991)
- Macari M., "CT of bowel wall thickening : significance and pitfalls of interpretation", AJR Am J Roentgenol, 176, pp.1105~1116 (2001)
- Nakayama K., "Genome comparison and phylogenetic analysis of Orientia tsutsugamushi strains", DNA Res, 17, pp.281~291 (2010)
- 김은실, "국내 환자에서 분리된 Orientia tsutsugamushi에서 doxycycline 내성", Infection and Chemotherapy, 40(5), pp.259~265 (2008), 대한감염학회
- 주고운, "Cholestatic Hepatitis Caused by Tongyeong Strain of Orientia tsutsugamushi", Infection and Chemotherapy, 41(2), pp.99~104 (2009), 대한감염학회
- Park SW., "Antigenic Drift of Orientia tsutsugamushi in South Korea as Identified by the Sequence Analysis of a 56-kDa Protein-Encoding Gene", AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 83, pp.930~935 (2010), AMER SOC TROP MED & HYGIENE
- Nakayama K., "The Whole-genome sequencing of the obligate intracellular bacterium Orientia tsutsugamushi revealed massive gene amplification during reductive genome evolution", DNA Res, 15, pp.185~199 (2008)
- Kelly DJ., "Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi", Clin Infect Dis, 48(Suppl 3), pp.S203~S230 (2009)