ABNORMAL LIVER FUNCTION IN SCRUB TYPHUS

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 Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

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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 Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

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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 Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

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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 Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

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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 Division of Hepatogastroenterology and Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

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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 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

Reprint requests: Chuan-Mo Lee, M.D., Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Hsiang 833, Kaohsiung Hsien, Taiwan, Republic of China, Telephone: 886-7-7317123 (ext. 8301), Fax: 886-7-7322402, E-mail: chmolee@ms15.hinet.net.
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