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Title: Septic shock secondary to scrub typhus: Characteristics and complications
Authors: Lon Chan Thap
Wichai Supanaranond
Sombat Treeprasertsuk
Sirima Kitvatanachai
Soontorn Chinprasatsak
Benjaluck Phonrat
National Malaria Center
Mahidol University
Rangsit University
Maharaj Nakhon Ratchasima Hospital
Keywords: Medicine
Issue Date: 1-Dec-2002
Citation: Southeast Asian Journal of Tropical Medicine and Public Health. Vol.33, No.4 (2002), 780-786
Abstract: Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.
ISSN: 01251562
Appears in Collections:Scopus 2001-2005

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