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Gastrointestinal manifestations of septic patients with scrub typhus in Maharat Nakhon Ratchasima Hospital.

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.

Authors+Show Affiliations

Department of Medical Research, Lower Myanmar, Ministry of Health, Myanmar, Thailand. athudmr@mail4u.com.mmNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15916079

Citation

Aung-Thu, , et al. "Gastrointestinal Manifestations of Septic Patients With Scrub Typhus in Maharat Nakhon Ratchasima Hospital." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 35, no. 4, 2004, pp. 845-51.
Aung-Thu , Supanaranond W, Phumiratanaprapin W, et al. Gastrointestinal manifestations of septic patients with scrub typhus in Maharat Nakhon Ratchasima Hospital. Southeast Asian J Trop Med Public Health. 2004;35(4):845-51.
Aung-Thu, ., Supanaranond, W., Phumiratanaprapin, W., Phonrat, B., Chinprasatsak, S., & Ratanajaratroj, N. (2004). Gastrointestinal manifestations of septic patients with scrub typhus in Maharat Nakhon Ratchasima Hospital. The Southeast Asian Journal of Tropical Medicine and Public Health, 35(4), pp. 845-51.
Aung-Thu , et al. Gastrointestinal Manifestations of Septic Patients With Scrub Typhus in Maharat Nakhon Ratchasima Hospital. Southeast Asian J Trop Med Public Health. 2004;35(4):845-51. PubMed PMID: 15916079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastrointestinal manifestations of septic patients with scrub typhus in Maharat Nakhon Ratchasima Hospital. AU - Aung-Thu,, AU - Supanaranond,Wichai, AU - Phumiratanaprapin,Weerapong, AU - Phonrat,Benjaluck, AU - Chinprasatsak,Soonthorn, AU - Ratanajaratroj,Nachapa, PY - 2005/5/27/pubmed PY - 2005/6/3/medline PY - 2005/5/27/entrez SP - 845 EP - 51 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J. Trop. Med. Public Health VL - 35 IS - 4 N2 - 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. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/15916079/Gastrointestinal_manifestations_of_septic_patients_with_scrub_typhus_in_Maharat_Nakhon_Ratchasima_Hospital_ L2 - http://www.diseaseinfosearch.org/result/7277 DB - PRIME DP - Unbound Medicine ER -