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Severe Scrub Typhus Confirmed Early via Immunohistochemical Staining

We describe a case of interstitial pneumonia that was confirmed as scrub typhus by immunohistochemical (IHC) staining of an eschar. When a patient presents with interstitial pneumonia accompanied by generalized lymphadenopathy on the thoracic CT scan, clinicians should suspect scrub typhus, especially when the patient has a history of travel to a scrub typhus-endemic area. IHC staining on an eschar revealed invasion by Orientia tsutsugamushi coccobacilli of the patient’s sweat ducts and glands as well as vascular endothelium. IHC staining of an eschar could be used as an early-confirmation diagnostic method to establish scrub typhus.

Received January 23, 2007. Accepted for publication June 12, 2007.

Acknowledgment: This study was supported by research funds from Chosun University, 2006.

^* Address correspondence to Won-Jong Jang, Department of Microbiology, Konkuk University College of Medicine, 322 Danwol-dong, Choongju-si, Choongbuk 380-701, Republic of Korea. E-mail: wjjang{at}kku.ac.kr

Authors’ addresses: Dong-Min Kim and Kyung Jun Won, Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-Gu, Gwangju 501-717, Republic of Korea, Telephone: +82-62-220-3108, Fax: +82-62-234-9653, E-mail: drongkim{at}chosun.ac.kr. Sung-Chul Lim, Department of Pathology and Research Center for Resistant Cells, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea, Telephone: +82-62-230-6343, Fax: +82-62-234-4584, E-mail: sclim{at}chosun.ac.kr. Yeon-Joo Choi, Kyung-Hee Park, and Won-Jong Jang, Department of Microbiology, Konkuk University College of Medicine, 322 Danwol-dong, Choongju-si, Choongbuk 380-701, Republic of Korea, Telephone: +82-43-840-3724, Fax: +82-43-851-9329, E-mail: wjjang{at}kku.ac.kr.

D. M. Kim and S. C. Lim contributed equally to this work.

Reprint requests: Dong-Min Kim, Division of Infectious Diseases, Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea. E-mail: drongkim{at}chosun.ac.kr.

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				D.-M. Kim, D. W. Kang, J. O. Kim, J. H. Chung, H. L. Kim, C. Y. Park, and S.-C. Lim Acute Renal Failure Due to Acute Tubular Necrosis Caused by Direct Invasion of Orientia tsutsugamushi J. Clin. Microbiol., April 1, 2008; 46(4): 1548 - 1550. [Abstract] [Full Text] [PDF]