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Scrub typhus: a frequently overlooked cause of acute renal failure.
Ren Fail. 2003 May; 25(3):397-410.RF

Abstract

Acute renal failure associated with scrub typhus infection is not rare as previously thought. The possibility of scrub typhus should be borne in mind when patients present with fever and varying degrees of acute renal failure, particularly if an eschar exists, along with a history of environmental exposure in an area like Taiwan, where scrub typhus is endemic. Prompt diagnosis and the use of appropriate antibiotics can rapidly alter the clinical course of the disease and prevent the development of serious or fatal complications. To illustrate the above point, this study reports 3 cases of scrub typhus associated with acute renal failure. They were seen at Chang Gung Memorial Hospital in a 2-year interval. Case 1 was referred from district hospital with clinical features of multiple organ dysfunctions, including shock, fever, acute respiratory failure, acute renal failure, and acute hepatitis. Case 2 was admitted with the chief problems of shock, fever, acute renal failure, and DIC. Case 3 visited our outpatient clinic due to fever, maculopapular rash and acute renal failure. In all these patients, the diagnosis was confirmed using immunofluorescence techniques, which showed that Orientia tsutsugamushi had an IgM titer of 1:80 or greater. Notably, despite having varying degrees of acute renal deterioration, the patients responded very well to doxycycline therapy and recovered completely. Additionally, a total of 4 similar cases of scrub typhus associated with acute renal failure were reviewed from the past literature.

Authors+Show Affiliations

Division of Nephrology, Chang Gung Memorial Hospital, Chang Gung Medical College and University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

12803503

Citation

Yen, Tzung-Hai, et al. "Scrub Typhus: a Frequently Overlooked Cause of Acute Renal Failure." Renal Failure, vol. 25, no. 3, 2003, pp. 397-410.
Yen TH, Chang CT, Lin JL, et al. Scrub typhus: a frequently overlooked cause of acute renal failure. Ren Fail. 2003;25(3):397-410.
Yen, T. H., Chang, C. T., Lin, J. L., Jiang, J. R., & Lee, K. F. (2003). Scrub typhus: a frequently overlooked cause of acute renal failure. Renal Failure, 25(3), 397-410.
Yen TH, et al. Scrub Typhus: a Frequently Overlooked Cause of Acute Renal Failure. Ren Fail. 2003;25(3):397-410. PubMed PMID: 12803503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scrub typhus: a frequently overlooked cause of acute renal failure. AU - Yen,Tzung-Hai, AU - Chang,Chiz-Tzung, AU - Lin,Ja-Liang, AU - Jiang,Jieh-Ran, AU - Lee,Kam-Fai, PY - 2003/6/14/pubmed PY - 2003/12/12/medline PY - 2003/6/14/entrez SP - 397 EP - 410 JF - Renal failure JO - Ren Fail VL - 25 IS - 3 N2 - Acute renal failure associated with scrub typhus infection is not rare as previously thought. The possibility of scrub typhus should be borne in mind when patients present with fever and varying degrees of acute renal failure, particularly if an eschar exists, along with a history of environmental exposure in an area like Taiwan, where scrub typhus is endemic. Prompt diagnosis and the use of appropriate antibiotics can rapidly alter the clinical course of the disease and prevent the development of serious or fatal complications. To illustrate the above point, this study reports 3 cases of scrub typhus associated with acute renal failure. They were seen at Chang Gung Memorial Hospital in a 2-year interval. Case 1 was referred from district hospital with clinical features of multiple organ dysfunctions, including shock, fever, acute respiratory failure, acute renal failure, and acute hepatitis. Case 2 was admitted with the chief problems of shock, fever, acute renal failure, and DIC. Case 3 visited our outpatient clinic due to fever, maculopapular rash and acute renal failure. In all these patients, the diagnosis was confirmed using immunofluorescence techniques, which showed that Orientia tsutsugamushi had an IgM titer of 1:80 or greater. Notably, despite having varying degrees of acute renal deterioration, the patients responded very well to doxycycline therapy and recovered completely. Additionally, a total of 4 similar cases of scrub typhus associated with acute renal failure were reviewed from the past literature. SN - 0886-022X UR - https://www.unboundmedicine.com/medline/citation/12803503/Scrub_typhus:_a_frequently_overlooked_cause_of_acute_renal_failure_ L2 - https://www.tandfonline.com/doi/full/10.1081/jdi-120021152 DB - PRIME DP - Unbound Medicine ER -