• 1.

    Hu ML, Liu JW, Wu KL, Lu SN, Chiou SS, Kuo CH, Chuah SK, Wang JH, Hu TH, Chiu KW, Lee CM, Changchien CS, 2005. Short report: abnormal liver function in scrub typhus. Am J Trop Med Hyg 73: 667668.

    • Search Google Scholar
    • Export Citation
  • 2.

    Basnyat B, Belbase RH, Zimmerman MD, Woods CW, Reller LB, Murdoch DR, 2006. Clinical features of scrub typhus. Clin Infect Dis 42: 15051506.

  • 3.

    Cuthbert JA, 2001. Hepatitis A: old and new. Clin Microbiol Rev 14: 3858.

  • 4.

    Koff RS, 1992. Clinical manifestations and diagnosis of hepatitis A virus infection. Vaccine 10: 15S17S.

  • 5.

    Lee TH, Kim SM, Lee GS, Im EH, Huh KC, Choi YW, Kang YW, 2006. Clinical features of acute hepatitis A in the western part of Daejeon and Chungnam Province: single center experience [in Korean]. Korean J Gastroenterol 47: 136143.

    • Search Google Scholar
    • Export Citation
  • 6.

    Lee J et al., 2007. Communicable Diseases Surveillance Yearbook—Viral Hepatitis. Seoul, South Korea: Korean Centers for Disease Control and Prevention, 409414.

    • Search Google Scholar
    • Export Citation
  • 7.

    Goddard J, 2000. Chigger mites and scrub typhus. Infect Med 17: 236239.

  • 8.

    Kim DM, Byun JN, 2008. Effects of antibiotic treatment on the results of nested PCRs for scrub typhus. J Clin Microbiol 46: 34653466.

  • 9.

    Kim DM, Yu KD, Lee JH, Kim HK, Lee SH, 2007. Controlled trial of a 5-day course of telithromycin versus doxycycline for treatment of mild to moderate scrub typhus. Antimicrob Agents Chemother 51: 20112015.

    • Search Google Scholar
    • Export Citation
  • 10.

    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.

    • Search Google Scholar
    • Export Citation
  • 11.

    Silpapojakul K, Varachit B, Silpapojakul K, 2004. Paediatric scrub typhus in Thailand: a study of 73 confirmed cases. Trans R Soc Trop Med Hyg 98: 354359.

    • Search Google Scholar
    • Export Citation
  • 12.

    Silpapojakul K, Chupuppakarn S, Yuthasompob S, Varachit B, Chaipak D, Borkerd T, Silpapojakul K, 1991. Scrub and murine typhus in children with obscure fever in the tropics. Pediatr Infect Dis J 10: 200203.

    • Search Google Scholar
    • Export Citation
  • 13.

    Fleischer B, Fleischer S, Maier K, Wiedmann KH, Sacher M, Thaler H, Valllbracht A, 1990. Clonal analysis of infiltrating T lymphocytes in liver tissue in viral hepatitis A. Immunology 69: 1419.

    • Search Google Scholar
    • Export Citation
  • 14.

    Baba M, Hasegawa H, Nakayabu M, Fukai K, Suzuki S, 1993. Cytolytic activity of natural killer cells and lymphokine activated killer cells against hepatitis A virus infected fibroblasts. J Clin Lab Immunol 40: 4760.

    • Search Google Scholar
    • Export Citation
  • 15.

    Scheuer PJ, Davies SE, Dhillon AP, 1996. Histopathological aspects of viral hepatitis. J Viral Hepat 3: 277283.

  • 16.

    El-Newihi HM, Alamy ME, Reynolds TB, 1996. Salmonella hepatitis: analysis of 27 cases and comparison with acute viral hepatitis. Hepatology 24: 516519.

    • Search Google Scholar
    • Export Citation
  • 17.

    Cassidy WM, Reynolds TB, 1994. Serum lactic dehydrogenase in the differential diagnosis of acute hepatocellular injury. J Clin Gastroenterol 19: 118121.

    • Search Google Scholar
    • Export Citation
  • 18.

    Young B, Gleeson M, Cripps AW, 1991. C-reactive protein: a critical review. Pathology 23: 118124.

Past two years Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 211 98 2
PDF Downloads 45 26 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

A Comparative Study of Hepatitis Caused by Scrub Typhus and Viral Hepatitis A in South Korea

View More View Less
  • Department of Internal Medicine, Research Center for Resistant Cells, and Department of Preventive Medicine, School of Medicine, Chosun University, Gwangju, South Korea
Restricted access

We compared clinical features and laboratory findings of 104 patients with hepatitis A and 197 patients with scrub typhus. Nausea, vomiting, abdominal pain, hepatomegaly, and jaundice were common in patient with hepatitis A, and fever and headache were significantly more common in patients with scrub typhus. At presentation, an alanine aminotransferase (ALT) level ≥ 500 U/L was observed in 1% of scrub typhus patients and in 87.5% of hepatitis A patients (P < 0.001). A bilirubin level ≥ 1.3 mg/dL was observed in 16.8% of scrub typhus patients and 90.4% of hepatitis A patients. The ALT:lactate dehydrogenase ratio was ≤ 5 in 97.4% of the patients with scrub typhus and > 5 in 95.2% of those with hepatitis A (P < 0.001). Fever, headache, rash, and eschar are findings that indicate scrub typhus. An ALT level ≥ 500 U/L (adjusted odds ratio = 0.011) a bilirubin level ≥ 1.3 (adjusted odds ratio = 0.024), an ALT:lactate dehydrogenase ratio > 5, and hepatomegaly are indications of viral hepatitis A.

Author Notes

*Address correspondence to Dong-Min Kim, Department of Internal Medicine, Chosun University College of Medicine 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, South Korea. E-mail: drongkim@chosun.ac.kr

Dislosure: None of the authors have any commercials interests or other associations that might be conflicts of interest.

Authors' addresses: Jun Lee, Dong-Min Kim, Na Ra Yun, Yu Mi Byeon, Chan Guk Park, and Man Woo Kim, Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-Gu, Gwangju 501-717, South Korea, E-mails: joon3640@hanmail.net, drongkim@chosun.ac.kr, shinenara@gmail.com, oboist98@hanmail.net, giydkim@chosun.ac.kr, drcgpark@chosun.ac.kr, and mwkim@chosun.ac.kr. Mi Ah Han, National Cancer Control Research Institute, National Cancer Center 323, Ilsandong-Gu, Goyang, Gyeonggi-do, South Korea, E-mail: mahan@ncc.re.kr.

Reprint requests: Dong-Min Kim, Division of Infectious Diseases, Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, South Korea, E-mail: drongkim@chosun.ac.kr.

Save