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KMID : 1144320120440060469
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감염과 화학요법
2012 Volume.44 No. 6 p.469 ~ p.472
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Severe Scrub Typhus with Enterocolitis by the Ikeda Strain of Orientia tsutsugamushi
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Kim Kyung-Han
Jung Dong-Sik
Kim Su-Young
Kim Bo-Sung
Han Seung-Hee
Jung Eui-Han
Lee Hyuck
Kim Dong-Min
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Abstract
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Scrub typhus is a mite-borne bacterial infection of humans that is caused by Orientia tsutsugamushi, which causes generalized vasculitis. The disease may involve the tissues of any organ system but no case with involvement of the lower gastrointestinal tract has been reported. We report a case of a 39-year old Korean male with enterocolitis of severe scrub typhus, of which the serotype was Ikeda strain. The patient was admitted to hospital with fever, abdominal pain and shock. He developed multi organ failure and frequent watery diarrhea. Abdominal computed tomography revealed diffuse edematous thickening of the entire small and colon with inflammation. Three days after admission, the antibody to O. tsutsugamushi was reported to be 1:320. He improved with doxycycline and azithromycin, and the persistent watery diarrhea stopped at 24 hours. This study shows that scrub typhus should be considered when the small and large intestine are affected. For the genotype of O. tsutsugamushi in Korea, additional studies of the impact of changes in the vector distribution on the genotype distribution will be needed.
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KEYWORD
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Orientia tsutsugamushi, Scrub typhus, Enterocolitis, Genotype
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