Clinical features of tsutsugamushi complicated with liver damage
Release date: 2007-12-03 Scrub typhus, also known as tsutsugamushi disease, is an acute infectious illness caused by the bacterium *Orientia tsutsugamushi*. It is transmitted through the bite of infected chiggers, and rodents serve as the primary reservoir. The disease typically presents with symptoms such as high fever, toxemia, rash, eschars, and swollen lymph nodes. However, when it complicates with liver damage, the clinical picture can become more complex and challenging to diagnose.
A study published in the *Chinese Journal of Infectious Diseases* on April 4th examined 49 cases of scrub typhus between March 1990 and June 2005. Among these, 36 patients were found to have liver involvement. The researchers aimed to better understand the clinical features of this condition. According to the findings by Zheng Yu and colleagues from the First Affiliated Hospital of Wenzhou Medical College, 73.5% of all scrub typhus patients in the study had some form of liver damage. Symptoms included nausea, vomiting, and bloating in several cases.
Laboratory results showed that 36 patients had elevated levels of serum ALT and AST, indicating liver inflammation. Nine patients had increased total bilirubin, while 16 showed elevated alkaline phosphatase (ALP). Albumin levels were reduced in 14 patients, suggesting impaired liver function. Ultrasound scans revealed liver enlargement in 13 cases, splenomegaly in 16, and ascites in 9. Fortunately, all patients recovered after treatment with chloramphenicol or tetracycline, along with liver-protective measures.
This study highlights the importance of considering scrub typhus in patients presenting with unexplained fever and liver dysfunction. Early diagnosis and prompt treatment are crucial for a full recovery. As the disease is often underdiagnosed, especially in endemic regions, awareness among healthcare providers is essential to improve outcomes.
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