1921
Volume 89, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis. We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis, and the therapeutic outcomes, and to determine the predictor factors. Cases were 22 patients with scrub typhus meningitis or meningoencephalitis, and controls were 303 patients without meningitis or meningoencephalitis. Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR] 8.9; < 0.001; confidence interval [CI] 2.9–27.2). Although appropriate antimicrobials such as doxycycline agents were administered at an early stage, meningitis or meningoencephalitis still occurred in some cases. Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline. Close observation and great care are essential for patients with risk factors, particularly pneumonitis.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.13-0224
2013-12-04
2017-11-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/89/6/1206.html?itemId=/content/journals/10.4269/ajtmh.13-0224&mimeType=html&fmt=ahah

References

  1. Kim SJ, Chung IK, Chung IS, Song DH, Park SH, Kim HS, Lee MH, , 2000. The clinical significance of upper gastrointestinal endoscopy in gastrointestinal vasculitis related to scrub typhus. Endoscopy 32: 950955.[Crossref]
  2. Ogawa M, Hagiwara T, Kishimoto T, Shiga S, Yoshida Y, Furuya Y, Kaiho I, Ito T, Nemoto H, Yamamoto N, Masukawa K, , 2002. Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998. Am J Trop Med Hyg 67: 162165.
  3. Thap LC, Supanaranond W, Treeprasertsuk S, Kitvatanachai S, Chinprasatsak S, Phonrat B, , 2002. Septic shock secondary to scrub typhus: characteristics and complications. Southeast Asian J Trop Med Public Health 33: 780786.
  4. Elsom KA, Beebe GW, Sayen JJ, Scheie HG, Gammon GD, Wood FC, , 1961. Scrub typhus: a follow-up study. Ann Intern Med 55: 784795.[Crossref]
  5. Silpapojakul K, Ukkachoke C, Krisanapan S, Silpapojakul K, , 1991. Rickettsial meningitis and encephalitis. Arch Intern Med 151: 17531757.[Crossref]
  6. Kim DM, Yun NR, Yang TY, Lee JH, Yang JT, Shim SK, Choi EN, Park MY, Lee SH, , 2006. Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study. Am J Trop Med Hyg 75: 542.
  7. Kim DM, Kim SW, Choi SH, Yun NR, , 2010. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis 10: 108.[Crossref]
  8. Lee J, Kim DM, Yun NR, Byeon YM, Kim YD, Park CG, Kim MW, Han MA, , 2011. A comparative study of hepatitis caused by scrub typhus and viral hepatitis A in South Korea. Am J Trop Med Hyg 85: 873877.[Crossref]
  9. World Health Organization (WHO), 2004. WHO Recommended Surveillance Standards. Second edition. Available at: http://www.who.int/emcdocuments/surveillance/docs/whocdscsrisr992.pdf. Accessed June 19, 2004.
  10. Ko AI, Galvao Reis M, Ribeiro Dourado CM, Johnson WD, Jr Riley LW, , 1999. Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Lancet 354: 820825.[Crossref]
  11. Yu M, Nardella A, Pechet L, , 2000. Screening tests of disseminated intravascular coagulation: guidelines for rapid and specific laboratory diagnosis. Crit Care Med 28: 17771780.[Crossref]
  12. Pai H, Sohn S, Seong Y, Kee S, Chang WH, Choe KW, , 1997. Central nervous system involvement in patients with scrub typhus. Clin Infect Dis 24: 436440.[Crossref]
  13. Vallejo-Maroto I, Garcia-Morillo S, Wittel MB, Stiefel P, Miranda M, Pamies E, Aparicio R, Carneado J, , 2002. Aseptic meningitis as a delayed neurologic complication of murine typhus. Clin Microbiol Infect 8: 826827.[Crossref]
  14. Dotevall L, Hagberg L, , 1989. Penetration of doxycycline into cerebrospinal fluid in patients treated for suspected Lyme neuroborreliosis. Antimicrob Agents Chemother 33: 10781080.[Crossref]
  15. Raoult D, Drancourt M, , 1991. Antimicrobial therapy of rickettsial diseases. Antimicrob Agents Chemother 35: 24572462.[Crossref]
  16. Yim CW, Flynn NM, Fitzgerald FT, , 1985. Penetration of oral doxycycline into the cerebrospinal fluid of patients with latent or neurosyphilis. Antimicrob Agents Chemother 28: 347348.[Crossref]
  17. Strickman D, Sheer T, Salata K, Hershey J, Dasch G, Kelly D, Kuschner R, , 1995. In vitro effectiveness of azithromycin against doxycycline-resistant and - susceptible strains of Rickettsia tsutsugamushi, etiologic agent of scrub typhus. Antimicrob Agents Chemother 39: 24062410.[Crossref]
  18. Mindermann T, Zimmerli W, Gratzl O, , 1998. Rifampin concentrations in various compartments of the human brain: a novel method for determining drug levels in the cerebral extracellular space. Antimicrob Agents Chemother 42: 26262629.
  19. Nau R, Prange HW, Menck S, Kolenda H, Visser K, Seydel JK, , 1992. Penetration of rifampicin into the cerebrospinal fluid of adults with uninflamed meninges. J Antimicrob Chemother 29: 719724.[Crossref]
  20. Cho BA, Ko Y, Kim YS, Kim S, Choi MS, Kim IS, Kim HR, Cho NH, , 2012. Phenotypic characterization of peripheral T cells and their dynamics in scrub typhus patients. PLoS Negl Trop Dis 6: e1789.[Crossref]
  21. Varghese GM, Abraham OC, Mathai D, Thomas K, Aaron R, Kavitha ML, Mathai E, , 2006. Scrub typhus among hospitalized patients with febrile illness in South India: magnitude and clinical predictors. J Infect 52: 5660.[Crossref]
  22. Song SW, Kim KT, Ku YM, Park SH, Kim YS, Lee DG, Yoon SA, Kim YO, , 2004. Clinical role of interstitial pneumonia in patients with scrub typhus: a possible marker of disease severity. J Korean Med Sci 19: 668673.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.13-0224
Loading
/content/journals/10.4269/ajtmh.13-0224
Loading

Data & Media loading...

  • Received : 26 Apr 2013
  • Accepted : 02 Sep 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error