Volume 73, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Scrub typhus is one kind of rickettsial disease and may cause fever, cough, and skin rashes in infected humans. Regarding liver involvement, it was uncommon to be reported in previous medical literature from Western countries. This study observes the relationship between scrub typhus and liver function. From January 1998 to August 2003 in Kaohsiung Chang Gung Memorial Hospital in Taiwan, we observed 30 patients with scrub typhus, and 29 of them had liver function abnormality. In these patients, we found 89.3% with elevated aspartate aminotransferase (AST) levels, 91.7% with elevated alanine aminotransferase (ALT) levels, 84.2% with elevated alkaline phosphatase (ALP) levels, and 38.5% with elevated total bilirubin levels. In our study, there is a close relationship between scrub typhus and impaired liver function tests. Therefore, if patients are found with fever of unknown origin and abnormal liver function, we should take scrub typhus into consideration.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Tamura A, Ohashi N, Urakami H, Miyamura S, 1995. Classification of Rickettsia tsutsugamushi in a new genus, Orientia gen nov, as Orientia tsutusgamushi comb nov. Int J Syst Bacteriol 45 : 589–591. [Google Scholar]
  2. Olson JG, Bourgeois AL, 1977. Rickettsia tsutsugamushi infection and scrub typhus incidence among Chinese military personnel in the Pescadores Islands. Am J Epidemiol 106 : 172–175. [Google Scholar]
  3. Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31 : 240–244. [Google Scholar]
  4. Chayakul P, Panich V, Silpapojakul K, 1988. Scrub typhus pneumonitis: an entity which is frequently missed. QJ Med 256 : 595–602. [Google Scholar]
  5. Alfred J, Saah, 2000. Orientia tsutsugamushi (scrub typhus). Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Volume 2. Fifth edition. New York: Churchill Livingstone, 2056–2057
  6. Furuya Y, Yoshida Y, Katayama T, Yamamoto S, Kawamura A, 1993. Serotype-specific amplification of Rickettsia tsutusgamushi DNA by nested polymerase chain reaction. J Clin Microbiol. 31 : 1637–1643. [Google Scholar]
  7. Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of microimmunofluorescence Test to the study of human Rickettsia tsutsugamushi antibody. Am J.Trop Med Hyg. 25 : 900–1005. [Google Scholar]
  8. Chen HL, Shieh GJ, Chen HY, Horng CB, 1995. Isolation of Rickettsia tsutsugamushi from the blood samples of patients in Taiwan. J Formos Med Assoc 94 : S112–S119. [Google Scholar]
  9. Center for Disease Control and Prevention, Taiwan. Available at http://www.cdc.gov.tw.
  10. Olson JG, Bourgeois AL, Fang RCY, Coolbaugh JC, Dennis DT, 1980. Prevention of scrub typhus, prophylactic administration of doxycycline in a randomized double blind trial. Am J Trop Med Hyg. 29 : 989–997. [Google Scholar]
  11. Twartz JC, Shirai A, Selvaraju G, Saunders JP, Huxsoll DL, Groves MG, 1982. Doxycycline prophylaxis for human scrub typhus. J infect Dis. 146 : 811–818. [Google Scholar]
  12. Sheehy TW, Hazlett D, Turk RE, 1973. Scrub typhus, a comparison of chloramphenicol and tetracycline in its treatment. Arch Intern Med. 132 : 77–80. [Google Scholar]
  13. Yang CH, Hsu GJ, Peng MY, Young TG, 1995. Hepatic dysfunction in scrub typhus. J Formos Med Assoc 94 : 101–105. [Google Scholar]
  14. Kanno A, Yamada M, Murakami K, Torinuki W, 1996. Liver involvement in Tsutsugamushi disease. Tohoku J Exp Med 179 : 213–217. [Google Scholar]
  15. Satoh T, Nagai K, Katoh T, Ishii K, Aikawa K, Inoue K, Hosaka H, Itoh K, Abei T, 1991. A case of hepatitis with granulomatous lesions by Rickettsia tsutsugamushi. Jpn J Gastroent 88 : 2827–2830. [Google Scholar]
  16. Chien RN, Liu NJ, Lin PY, Liaw YF, 1995. Granulomatous hepatitis associated with scrub typhus. J. Gastroenterol and Hepatol. 10 : 484–487. [Google Scholar]
  17. Pongponratn E, Maneerat Y, Chaisri U, Wilairatana P, Punpoowong B, Viriyavejakul P, Riganti M, 1998. Electron-microscopic examination of Rickettsia tsutsugamushi-infected human liver. Trop Med Int Health 3 : 242–248. [Google Scholar]

Data & Media loading...

  • Received : 02 Feb 2005
  • Accepted : 29 Apr 2005

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