Scrub Typhus: A Follow-up Study

Elsom, Kendall A.

doi:10.7326/0003-4819-55-5-784

Cited by 19 publications

(10 citation statements)

References 7 publications

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“…13 The rate of penetration of doxycycline into the brain or CSF is only 15-30% of that into the bloodstream. [14][15][16] A study of doxycycline concentrations in the CSF, 4 reported that 5-8 days after the start of therapy in Lyme neuroborreliosis, doxycycline concentrations above the minimum inhibitory concentration for Borrelia burgdorferi (0.6 μg/mL) were present in nine of 10 patients treated orally with doxycycline 200 mg bid, but in only three of 12 patients treated orally with doxycycline 100 mg bid. In contrast, a study of patients with non-inflamed meninges showed that the mean rifampin concentration in brain tissue was 0.29 μg/mL, whereas in the CSF it was 0.73 μg/mL (range, 0.57-1.24 μg/mL).…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Meningitis and meningoencephalitis are life-threatening manifestations that can cause changes in mentation and death. 4 Thus, early diagnosis and treatment are mandatory. Although many sporadic cases have been reported since Palm first described scrub typhus in 1878, there have been few studies of the clinical features and factors associated with scrub typhus meningitis and meningoencephalitis employing a large series of patients.…”

Section: Introductionmentioning

confidence: 99%

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Scrub Typhus Meningitis or Meningoencephalitis

Kim

Chung²,

Yun³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Orientia tsutsugamushi induces vasculitis leading to symptoms of systemic organ invasion including meningitis and meningoencephalitis. We conducted a retrospective case-control study of scrub typhus patients to investigate the clinical and laboratory features of patients with scrub typhus meningitis or meningoencephalitis, and the therapeutic outcomes, and to determine the predictor factors. Cases were 22 patients with scrub typhus meningitis or meningoencephalitis, and controls were 303 patients without meningitis or meningoencephalitis. Multivariate analysis showed that the presence of pneumonitis was associated with the occurrence of scrub typhus meningitis and meningoencephalitis (odds ratio [OR] 8.9; P 0.001; confidence interval [CI] 2.9-27.2). Although appropriate antimicrobials such as doxycycline agents were administered at an early stage, meningitis or meningoencephalitis still occurred in some cases. Physicians should be aware that meningitis or meningoencephalitis may develop during appropriate drug therapy such as doxycycline. Close observation and great care are essential for patients with risk factors, particularly pneumonitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Scrub Typhus Meningitis or Meningoencephalitis

Kim

Chung²,

Yun³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…Focal clusters and focal geographic "hot spots" of scrub typhus have been recognized for more than 60 years. For example, during World War II, more than 18,000 cases occurred in Allied soldiers, and 1255 people became ill with scrub typhus on two small islands off the coast of Dutch New Guinea during a 4-month period [19,20].…”

Section: Scrub Typhus (Orientia Tsutsugamushi Infection)mentioning

confidence: 99%

Scrub typhus and rickettsial diseases in international travelers: A review

Hendershot

Sexton²

2008

Curr Infect Dis Rep

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Physicians caring for febrile returned travelers face the difficult task of recognizing the typical and atypical features of more than 16 known rickettsial diseases and separating these diseases from potentially serious nonrickettsial diseases. Currently available diagnostic tools are inadequate for timely diagnosis. This review summarizes the English-language literature concerning imported rickettsial diseases in international travelers and describes important clinical principles in diagnosis and treatment of these illnesses. -Travelers with imported rickettsial disease often become sick before or within a few days of return from an endemic region. Illness that begins more than 18 days after return is unlikely to be rickettsial in origin. The absence of a skin rash or exposure to a vector should not dissuade clinicians from considering the possibility of a rickettsial disease in a returned traveler. Finally, if empiric therapy does not result in defervescence within 48 hours, an alternative nonrickettsial illness should be strongly considered.

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“…1 Fortunately, its incidence today is not as high as it was in the past; during World War II, 18 000 cases of scrub typhus occurred among allied military personnel. 2 However, rickettsioses continue to constitute major health problems in many parts of the world, and their prompt recognition is becoming more important to physicians because of increased international travel. 3 Another important reason for the early diagnosis of rickettsioses is their excellent response to treatment.…”

mentioning

confidence: 99%