• 1.

    Koh GC, Maude RJ, Paris DH, Newton PN, Blacksell SD, 2010. Diagnosis of scrub typhus. Am J Trop Med Hyg 82: 368370.

  • 2.

    Furuya Y, Yoshida Y, Katayama T, Yamamoto S, Kawamura A Jr, 1993. Serotype-specific amplification of Rickettsia tsutsugamushi DNA by nested polymerase chain reaction. J Clin Microbiol 31: 16371640.

    • Search Google Scholar
    • Export Citation
  • 3.

    Rajapakse S, Rodrigo C, Fernando D, 2012. Scrub typhus: pathophysiology, clinical manifestations and prognosis. Asian Pac J Trop Med. 5: 261264.

    • Search Google Scholar
    • Export Citation
  • 4.

    Botelho-Nevers E, Raoult D, 2007. Fever of unknown origin due to rickettsioses. Infect Dis Clin North Am 21: 9971011.

  • 5.

    Blacksell SD, Bryant NJ, Paris DH, Doust JA, Sakoda Y, Day NP, 2007. Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion. Clin Infect Dis 44: 391401.

    • Search Google Scholar
    • Export Citation
  • 6.

    Iwasaki H, Mizoguchi J, Takada N, Tai K, Ikegaya S, Ueda T, 2010. Correlation between the concentrations of tumor necrosis factor-alpha and the severity of disease in patients infected with Orientia tsutsugamushi. Int J Infect Dis 14: e328e333.

    • Search Google Scholar
    • Export Citation
  • 7.

    Ohashi N, Koyama Y, Urakami H, Fukuhara M, Tamura A, Kawamori F, Yamamoto S, Kasuya S, Yoshimura K, 1996. Demonstration of antigenic and genotypic variation in Orientia tsutsugamushi which were isolated in Japan, and their classification into type and subtype. Microbiol Immunol 40: 627638.

    • Search Google Scholar
    • Export Citation
  • 8.

    Kawamori F, Akiyama M, Sugieda M, Kanda T, Akahane S, Uchikawa K, Yamada Y, Kumada N, Furuya Y, Yoshida Y, 1992. Epidemiology of Tsutsugamushi disease in relation to the serotypes of Rickettsia tsutsugamushi isolated from patients, field mice, and unfed chiggers on the eastern slope of Mount Fuji, Shizuoka Prefecture, Japan. J Clin Microbiol 30: 28422846.

    • Search Google Scholar
    • Export Citation
  • 9.

    Ogawa M, Ono T, 2008. Epidemiological characteristics of tsutsugamushi disease in Oita Prefecture, Japan: yearly and monthly occurrences of its infections and serotypes of its causative agent, Orientia tsutsugamushi, during 1984–2005. Microbiol Immunol 52: 135143.

    • Search Google Scholar
    • Export Citation
  • 10.

    Tamura A, Takahashi K, Tsuruhara T, Urakami H, Miyamura S, Sekikawa H, Kenmotsu M, Shibata M, Abe S, Nezu H, 1984. Isolation of Rickettsia tsutsugamushi antigenically different from Kato, Karp, and Gilliam strains from patients. Microbiol Immunol 28: 873882.

    • Search Google Scholar
    • Export Citation
  • 11.

    Otani K, Kaneko A, Aoki T, Fujita H, 2009. A case report of Shimokoshi type Orientia tsutsugamushi from Yamagata Prefecture, Japan. Med Entomol Zool 60: 317321.

    • Search Google Scholar
    • Export Citation
  • 12.

    Furuya Y, 2012. Re-emerging infectious disease – Tsutsugamushi disease. Bull Kanagawa Ins of PH 42: 110.

Past two years Past Year Past 30 Days
Abstract Views 1 1 1
Full Text Views 295 111 0
PDF Downloads 82 32 0
 
 
 
 
 
 
 
 
 
 
 

Tsutsugamushi Disease Caused by Shimokoshi-Type Orientia tsutsugamushi: The First Report in Western Japan

Satoshi IkegayaDivision of Hematology and Oncology, Division of Infection Control and Senior Fellow Laboratory, University of Fukui, Fukui, Japan; Miyazaki Prefectural Institute of Public Health, Miyazaki, Japan

Search for other papers by Satoshi Ikegaya in
Current site
Google Scholar
PubMed
Close
,
Hiromichi IwasakiDivision of Hematology and Oncology, Division of Infection Control and Senior Fellow Laboratory, University of Fukui, Fukui, Japan; Miyazaki Prefectural Institute of Public Health, Miyazaki, Japan

Search for other papers by Hiromichi Iwasaki in
Current site
Google Scholar
PubMed
Close
,
Nobuhiro TakadaDivision of Hematology and Oncology, Division of Infection Control and Senior Fellow Laboratory, University of Fukui, Fukui, Japan; Miyazaki Prefectural Institute of Public Health, Miyazaki, Japan

Search for other papers by Nobuhiro Takada in
Current site
Google Scholar
PubMed
Close
,
Seigo YamamotoDivision of Hematology and Oncology, Division of Infection Control and Senior Fellow Laboratory, University of Fukui, Fukui, Japan; Miyazaki Prefectural Institute of Public Health, Miyazaki, Japan

Search for other papers by Seigo Yamamoto in
Current site
Google Scholar
PubMed
Close
, and
Takanori UedaDivision of Hematology and Oncology, Division of Infection Control and Senior Fellow Laboratory, University of Fukui, Fukui, Japan; Miyazaki Prefectural Institute of Public Health, Miyazaki, Japan

Search for other papers by Takanori Ueda in
Current site
Google Scholar
PubMed
Close
View More View Less
Restricted access

An 85-year-old female farmer was admitted to our hospital for fever, general fatigue, and skin rash. Cephalosporin was not effective and minocycline was dramatically effective. An eschar was discovered on her inguinal region after the defervescence. Laboratory examination of serum taken 12 days after onset of the illness showed elevated titers of antibodies against the Shimokoshi strain of Orientia tsutsugamushi. The gene sequence analysis of specimen from the patient's eschar revealed high similarity to the Shimokoshi strain by nested polymerase chain reaction. Therefore, this patient was diagnosed as a case of Shimokoshi-type tsutsugamushi disease, which has not previously been reported in Western Japan. Recently, cases of this type have also been confirmed in northeastern Japan, suggesting the need for further epidemiological studies.

Author Notes

* Address correspondence to Satoshi Ikegaya, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui 910-1193, Japan. E-mail: sikegaya@u-fukui.ac.jp

Financial support: This work was supported by Grant-in-Aid for Scientific Research 24591478 and a grant from The Ministry of Health, Labour and Welfare, Japan.

Authors' addresses: Satoshi Ikegaya, University of Fukui, Division of Hematology and Oncology, Fukui, Japan, E-mail: sikegaya@u-fukui.ac.jp. Hiromichi Iwasaki, University of Fukui, Division of Infection Control, Fukui, Japan, E-mail: hiwasaki@u-fukui.ac.jp. Nobuhiro Takada, University of Fukui, Senior Fellow Laboratory, Fukui, Japan, E-mail: acari@u-fukui.ac.jp. Seigo Yamamoto, Miyazaki Perfectural Institute of Public Health, Division of Bacteria, Miyazaki, Japan, E-mail: yamamoto-seigo@pref.miyazaki.lg.jp. Takanori Ueda, University of Fukui, Division of Hematology and Oncology, Fukui, Japan, E-mail: tueda@u-fukui.ac.jp.

Save