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-
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.
-
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.
-
3
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31 :240–244.
-
4
Chayakul P, Panich V, Silpapojakul K, 1988. Scrub typhus pneumonitis: an entity which is frequently missed. QJ Med 256 :595–602.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
13
Yang CH, Hsu GJ, Peng MY, Young TG, 1995. Hepatic dysfunction in scrub typhus. J Formos Med Assoc 94 :101–105.
-
14
Kanno A, Yamada M, Murakami K, Torinuki W, 1996. Liver involvement in Tsutsugamushi disease. Tohoku J Exp Med 179 :213–217.
-
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.
-
16
Chien RN, Liu NJ, Lin PY, Liaw YF, 1995. Granulomatous hepatitis associated with scrub typhus. J. Gastroenterol and Hepatol. 10 :484–487.
-
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.
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ABNORMAL LIVER FUNCTION IN SCRUB TYPHUS
MING-LUEN HU
MING-LUEN HU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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JIEN-WEI LIU
JIEN-WEI LIU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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KENG-LIANG WU
KENG-LIANG WU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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SHENG-NAN LU
SHENG-NAN LU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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SHUE-SHIAN CHIOU
SHUE-SHIAN CHIOU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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CHUNG-HUANG KUO
CHUNG-HUANG KUO
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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SENG-KEE CHUAH
SENG-KEE CHUAH
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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JING-HOUNG WANG
JING-HOUNG WANG
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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TSUNG-HUI HU
TSUNG-HUI HU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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KING-WAH CHIU
KING-WAH CHIU
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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CHUAN-MO LEE
CHUAN-MO LEE
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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CHI-SIN CHANGCHIEN
CHI-SIN CHANGCHIEN
Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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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.
Author Notes
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-
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.
-
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.
-
3
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31 :240–244.
-
4
Chayakul P, Panich V, Silpapojakul K, 1988. Scrub typhus pneumonitis: an entity which is frequently missed. QJ Med 256 :595–602.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
13
Yang CH, Hsu GJ, Peng MY, Young TG, 1995. Hepatic dysfunction in scrub typhus. J Formos Med Assoc 94 :101–105.
-
14
Kanno A, Yamada M, Murakami K, Torinuki W, 1996. Liver involvement in Tsutsugamushi disease. Tohoku J Exp Med 179 :213–217.
-
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.
-
16
Chien RN, Liu NJ, Lin PY, Liaw YF, 1995. Granulomatous hepatitis associated with scrub typhus. J. Gastroenterol and Hepatol. 10 :484–487.
-
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.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 60 | 60 | 25 |
| Full Text Views | 528 | 126 | 1 |
| PDF Downloads | 285 | 63 | 1 |