Author:
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Patient characteristics.
- The frequency of ECG abnormality at admission in patients with scrub typhus.
- Comparison of ECG abnormalities between the health checkup group and patients with scrub typhus.
- Comparison among patients with scrub typhus according to the presence of ECG abnormalities at admission.
- Comparison between the normal ECG group and abnormal ECG subgroups at admission in patients with scrub typhus.
- DISCUSSION
ProCite
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Reference Manager
BibTeX
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-
1.
Elisberg BL, Campbell JM, Bozeman FM, 1968. Antigenic diversity of rickettsia tsutsugamushi: epidemiologic and ecologic significance. J Hyg Epidemiol Microbiol Immunol 12: 18–25.
-
2.
Jensenius M, Fournier PE, Raoult D, 2004. Rickettsioses and the international traveler. Clin Infect Dis 39: 1493–1499.
-
3.
Jensenius M, Montelius R, Berild D, Vene S, 2006. Scrub typhus imported to Scandinavia. Scand J Infect Dis 38: 200–202.
-
4.
Cracco C, Delafosse C, Baril L, Lefort Y, Morelot C, Derenne JP, Bricaire F, Similowski T, 2000. Multiple organ failure complicating probable scrub typhus. Clin Infect Dis 31: 191–192.
-
5.
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31: 240–244.
-
6.
Blackburn H, Keys A, Simonson E, Rautaharju P, Punsar S, 1960. The electrocardiogram in population studies. A classification system. Circulation 21: 1160–1175.
-
7.
Keller CA, Hauptmann M, Kolbaum J, Gharaibeh M, Neumann M, Glatzel M, Fleischer B, 2014. Dissemination of Orientia tsutsugamushi and inflammatory responses in a murine model of scrub typhus. PLoS Negl Trop Dis 8: e3064.
-
8.
Thipmontree W, Tantibhedhyangkul W, Silpasakorn S, Wongsawat E, Waywa D, Suputtamongkol Y, 2016. Scrub typhus in northeastern Thailand: eschar distribution, abnormal electrocardiographic findings, and predictors of fatal outcome. Am J Trop Med Hyg 95: 769–773.
-
9.
Howell WL, 1945. Absence of electrocardiographic changes in Tsutsugamushi fever (scrub typhus); report of two hundred consecutive cases. Arch Intern Med (Chic) 76: 217.
-
10.
Watt G, Kantipong P, Jirajarus K, 2002. Acute scrub typhus in Northern Thailand: EKG changes. Southeast Asian J Trop Med Public Health 33: 312–313.
-
11.
Kim JM, Hyun M, Kim HA, Kim MK, Kim JY, Kwon KY, Ryu SY, 2014. A review of the electrocardiography changes and clinical manifestations of scrub typhus in a single center. Korean J Med 86: 301–307.
-
12.
Hong SP, Kim DM, 2014. A review of electrocardiography changes and clinical manifestation in scrub typhus in a single center. J Korean Internal Med 86: 298–300.
-
13.
Son MK, Lim NK, Cho MC, Park HY, 2016. Incidence and risk factors for atrial fibrillation in Korea: the national health insurance service database (2002–2010). Korean Circ J 46: 515–521.
-
14.
Sittiwangkul R, Pongprot Y, Silviliarat S, Oberdorfer P, Jittamala P, Sirisanthana V, 2008. Acute fulminant myocarditis in scrub typhus. Ann Trop Paediatr 28: 149–154.
-
15.
Kim DG, Kim JW, Choi YS, Kim SH, Kim SM, Park CG, Seo HS, Oh DJ, 2007. Acute myocardial infarction following scrub typhus infection. Int J Cardiol 114: e18–e20.
-
16.
Levine HD, 1946. Pathologic study of thirty-one cases of scrub typhus fever with especial reference to the cardiovascular system. Am Heart J 31: 314–328.
-
17.
Irons EM, Armstrong HE, 1947. Scrub typhus in Dutch New Guinea. Ann Intern Med 26: 201–220.
-
18.
Woodward TE, Mc CF Jr., Carey TN, Togo Y, 1960. Viral and rickettsial causes of cardiac disease, including the coxsackie virus etiology of pericarditis and myocarditis. Ann Intern Med 53: 1130–1150.
-
19.
McGowan GK, Walters G, 1976. Ventricular arrhythmias and hypokalemia. Lancet 2: 964.
-
20.
Mineoi K, Matsuoka H, Sumimoto T, Kawada H, Hamada M, Hiwada K, Kondoh T, Ochi T, 1992. Torsade de pointes induced by hypocalcemia in a postoperative patient with thyrotoxicosis. Jpn Heart J 33: 735–738.
-
21.
Lim JH, Kim ES, Chung MH, Kang JS, 2008. Torsades de pointes by azithromycin in scrub typhus and review on cardiac manifestations of scrub typhus. Infect Chemother 40: 58–62.
-
22.
Prineas RJ, Crow RS, Zhang ZM, 2010. The Minnesota Code Manual of Electrocardiographic Findings, Standards and Procedures for Measurement and Classification. 2nd edn. London, UK: Springer.
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Scrub Typhus and Abnormal Electrocardiography
Seo-Won Choi
Seo-Won Choi
Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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Na Ra Yun
Na Ra Yun
Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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Dong-Hyun Choi
Dong-Hyun Choi
Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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Young-Jae Ki
Young-Jae Ki
Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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Seok Won Kim
Seok Won Kim
Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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Choon-Mee Kim
Choon-Mee Kim
The Division of Natural Medical Sciences, College of Health Science, Chosun University, Gwangju, Republic of Korea
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Dong-Min Kim
Dong-Min Kim
Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea;
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This study compared the frequency of abnormal electrocardiogram (ECG) types between scrub typhus patient group and age- and gender-matched health checkup group and their associations with disease severity in scrub typhus patient. Demographic characteristics and ECG and laboratory findings of patients with scrub typhus admitted to Chosun University Hospital, and normal subjects visiting the hospital for health checkup from January 2008 to December 2012 were retrospectively studied. Electrocardiogram abnormalities at admission were observed in 72 of 165 (43.6%) scrub typhus confirmed patients. The following ECG abnormalities were observed: arrhythmic group (31 cases, 18.8%), ischemic change group (25 cases, 15.1%), prolonged QT group (32 cases, 19.4%).Compared with the age and gender-matched health checkup group, ECG abnormalities were more commonly observed in scrub typhus patient group (13.9% versus 43.6%, P < 0.001). In addition, when compared with the normal ECG group, scrub typhus in the abnormal ECG group showed greater disease severity and this phenomenon was particularly prominent in the prolonged QT group. Based on our study prolonged QT observed in approximately 20% of patients with scrub typhus, clinicians should pay additional attention to drugs that affect QT interval.
Author Notes
Authors’ addresses: Seo-Won Choi, Na Ra Yun, Dong-Hyun Choi, Young-Jae Ki, and Dong-Min Kim, Internal medicine, Chosun University, College of Medicine, Gwangju, Republic of Korea, E-mails: mdswchoi@gmail.com, shine@chosun.ac.kr, dhchoi@chosun.ac.kr, bonds0427@naver.com, and drongkim@chosun.ac.kr. Seok Won Kim, Department of Neurosurgery, Chosun University College of Medicine, Gwangju, Republic of Korea, E-mail: chosunns@chosun.ac.kr. Choon-Mee Kim, Premedical Science, College of Medicine, Gwangju, Republic of Korea, E-mail: choonmee@chosun.ac.kr.
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Patient characteristics.
- The frequency of ECG abnormality at admission in patients with scrub typhus.
- Comparison of ECG abnormalities between the health checkup group and patients with scrub typhus.
- Comparison among patients with scrub typhus according to the presence of ECG abnormalities at admission.
- Comparison between the normal ECG group and abnormal ECG subgroups at admission in patients with scrub typhus.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Elisberg BL, Campbell JM, Bozeman FM, 1968. Antigenic diversity of rickettsia tsutsugamushi: epidemiologic and ecologic significance. J Hyg Epidemiol Microbiol Immunol 12: 18–25.
-
2.
Jensenius M, Fournier PE, Raoult D, 2004. Rickettsioses and the international traveler. Clin Infect Dis 39: 1493–1499.
-
3.
Jensenius M, Montelius R, Berild D, Vene S, 2006. Scrub typhus imported to Scandinavia. Scand J Infect Dis 38: 200–202.
-
4.
Cracco C, Delafosse C, Baril L, Lefort Y, Morelot C, Derenne JP, Bricaire F, Similowski T, 2000. Multiple organ failure complicating probable scrub typhus. Clin Infect Dis 31: 191–192.
-
5.
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31: 240–244.
-
6.
Blackburn H, Keys A, Simonson E, Rautaharju P, Punsar S, 1960. The electrocardiogram in population studies. A classification system. Circulation 21: 1160–1175.
-
7.
Keller CA, Hauptmann M, Kolbaum J, Gharaibeh M, Neumann M, Glatzel M, Fleischer B, 2014. Dissemination of Orientia tsutsugamushi and inflammatory responses in a murine model of scrub typhus. PLoS Negl Trop Dis 8: e3064.
-
8.
Thipmontree W, Tantibhedhyangkul W, Silpasakorn S, Wongsawat E, Waywa D, Suputtamongkol Y, 2016. Scrub typhus in northeastern Thailand: eschar distribution, abnormal electrocardiographic findings, and predictors of fatal outcome. Am J Trop Med Hyg 95: 769–773.
-
9.
Howell WL, 1945. Absence of electrocardiographic changes in Tsutsugamushi fever (scrub typhus); report of two hundred consecutive cases. Arch Intern Med (Chic) 76: 217.
-
10.
Watt G, Kantipong P, Jirajarus K, 2002. Acute scrub typhus in Northern Thailand: EKG changes. Southeast Asian J Trop Med Public Health 33: 312–313.
-
11.
Kim JM, Hyun M, Kim HA, Kim MK, Kim JY, Kwon KY, Ryu SY, 2014. A review of the electrocardiography changes and clinical manifestations of scrub typhus in a single center. Korean J Med 86: 301–307.
-
12.
Hong SP, Kim DM, 2014. A review of electrocardiography changes and clinical manifestation in scrub typhus in a single center. J Korean Internal Med 86: 298–300.
-
13.
Son MK, Lim NK, Cho MC, Park HY, 2016. Incidence and risk factors for atrial fibrillation in Korea: the national health insurance service database (2002–2010). Korean Circ J 46: 515–521.
-
14.
Sittiwangkul R, Pongprot Y, Silviliarat S, Oberdorfer P, Jittamala P, Sirisanthana V, 2008. Acute fulminant myocarditis in scrub typhus. Ann Trop Paediatr 28: 149–154.
-
15.
Kim DG, Kim JW, Choi YS, Kim SH, Kim SM, Park CG, Seo HS, Oh DJ, 2007. Acute myocardial infarction following scrub typhus infection. Int J Cardiol 114: e18–e20.
-
16.
Levine HD, 1946. Pathologic study of thirty-one cases of scrub typhus fever with especial reference to the cardiovascular system. Am Heart J 31: 314–328.
-
17.
Irons EM, Armstrong HE, 1947. Scrub typhus in Dutch New Guinea. Ann Intern Med 26: 201–220.
-
18.
Woodward TE, Mc CF Jr., Carey TN, Togo Y, 1960. Viral and rickettsial causes of cardiac disease, including the coxsackie virus etiology of pericarditis and myocarditis. Ann Intern Med 53: 1130–1150.
-
19.
McGowan GK, Walters G, 1976. Ventricular arrhythmias and hypokalemia. Lancet 2: 964.
-
20.
Mineoi K, Matsuoka H, Sumimoto T, Kawada H, Hamada M, Hiwada K, Kondoh T, Ochi T, 1992. Torsade de pointes induced by hypocalcemia in a postoperative patient with thyrotoxicosis. Jpn Heart J 33: 735–738.
-
21.
Lim JH, Kim ES, Chung MH, Kang JS, 2008. Torsades de pointes by azithromycin in scrub typhus and review on cardiac manifestations of scrub typhus. Infect Chemother 40: 58–62.
-
22.
Prineas RJ, Crow RS, Zhang ZM, 2010. The Minnesota Code Manual of Electrocardiographic Findings, Standards and Procedures for Measurement and Classification. 2nd edn. London, UK: Springer.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 34 | 34 | 6 |
| Full Text Views | 389 | 96 | 0 |
| PDF Downloads | 161 | 43 | 0 |