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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/21469
Title: Gastrointestinal manifestations of septic patients with scrub typhus in maharat nakhon ratchasima hospital
Authors: Aung-Thu
Wichai Supanaranond
Weerapong Phumiratanaprapin
Benjaluck Phonrat
Soonthorn Chinprasatsak
Nachapa Ratanajaratroj
Lower Myanmar
Mahidol University
Maharaj Nakhon Ratchasima Hospital
Epidemiology Research Division
Keywords: Medicine
Issue Date: 1-Dec-2004
Citation: Southeast Asian Journal of Tropical Medicine and Public Health. Vol.35, No.4 (2004), 845-851
Abstract: Scrub typhus is an acute febrile illness caused by Orientia induced vasculitis, which is common in Asia and the Pacific Islands and is sometimes also encountered in Western countries. Even though it can cause multi-organ dysfunctions, there is limited information regarding the relationship between scrub typhus infection and gastrointestinal dysfunction. Therefore, a cross-sectional study was conducted to discover the gastrointestinal manifestations of septic patients with scrub typhus infection. During the study period, 80 septic cases were recruited, and according to the results of immunofluorescent antibody testing (IFA), 20 (25%) were found to have scrub typhus infection. The most common gastrointestinal symptoms of scrub typhus patients were vomiting 13 (65%), nausea 12 (60%), diarrhea 9 (45%), and hametamesis or melena 5 (25%). Gastrointestinal signs included hepatomegaly 8 (40%), jaundice 7 (35%), and abdominal pain 4 (20%). Elevation of SGOT, SGPT, and alkaline phosphatase were 16 (80%), 14 (70%), and 16 (80%), respectively. Direct bilirubin was elevated in 19 (95%) of the cases and half of the cases had a low serum protein level. Of scrub typhus cases, 8 (40%) had eschars. The sites of eschars were mostly in hidden areas, such as on the back, genitalia and abdomen. Three of the five patients with eschar had hepatomegaly on ultrasound examination. The significant findings of the scrub typhus septic patients with eschar on endoscopic examination were gastritis in two cases, gastritis with gastric erosion in two cases, and one case showed a duodenal ulcer and erosion. The differentiating point for endoscopic findings in scrub typhus compared to the other causes was that the stomach lesions were more frequent and severe than the duodenal lesions. According to our endoscopic findings, physicians should be aware of gastric and duodenal lesions in febrile patients with gastrointestinal symptoms, such as abdominal pain or discomfort and indigestion. Scrub typhus can cause gastrointestinal and liver dysfunction.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=12444256800&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/21469
ISSN: 01251562
Appears in Collections:Scopus 2001-2005

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