Clinical features of tsutsugamushi complicated with liver damage

Release date: 2007-12-03

Clinical Features of Scrub Typhus Complicated with Liver Damage Scrub typhus, also known as tsutsugamushi disease, is an acute infectious illness caused by the bacterium *Orientia tsutsugamushi*. It is transmitted by chiggers, and rodents serve as the primary reservoirs. The condition is characterized by high fever, toxemia, rash, eschars, and swollen lymph nodes. While ascariasis is often associated with liver damage, it's important to note that scrub typhus should be considered in patients presenting with unexplained fever and hepatic abnormalities. A study published in the *Chinese Journal of Infectious Diseases* on April 4th analyzed clinical data from 49 cases of scrub typhus treated between March 1990 and June 2005. Among these, 36 patients showed signs of liver damage, representing 73.5% of all cases. Symptoms included nausea, vomiting, and bloating. Laboratory findings revealed elevated levels of serum ALT and AST, with 9 patients showing increased total bilirubin and 16 with elevated alkaline phosphatase. Albumin levels were reduced in 14 cases. Ultrasound scans indicated hepatomegaly in 13 patients, splenomegaly in 16, and ascites in 9. All patients recovered after treatment with chloramphenicol or tetracycline, along with supportive liver protection therapy. This highlights the importance of considering scrub typhus in the differential diagnosis for patients with unexplained fever and liver dysfunction. Early recognition and appropriate treatment are key to successful outcomes. —— Midi Medical Network