Identification of the Target Cells of Orientia tsutsugamushi in Human Cases of Scrub Typhus

Morón, Cecilia; Popov, Vsevolod L.; Feng, Hui; Wear, Douglas J.; Walker, David H.

doi:10.1038/modpathol.3880385

Cited by 167 publications

(153 citation statements)

References 22 publications

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“…tsutsugamushi infection spreads to multiple organs through blood stream and lymphatics. It predominately targets the macrophages present in the spleen and liver [6]. The Rickettsia attacks the endothelial cells causing inflammation by a mechanism called oxidative stress leading onto local and systemic vasculitis [7].…”

Section: Discussionmentioning

confidence: 99%

Isolated neurocutaneous peripheral T cell lymphoma, NOS

Lakshmanan¹,

Seetharaman²,

Sr³

et al. 2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A 62-year-old female, farmer by occupation who presented to us with features of acute respiratory distress syndrome (ARDS) and meningitis, subsequently developed gangrene of digits of all four limbs. We investigated the patient for infectious and non-infectious causes of vasculitis leading onto gangrene. We attributed the cause for pan-digital gangrene as scrub typhus as evidenced by the presence of eschar and positive serology. Patient recovered with ventilatory support and antibiotics though her digits could not be salvaged which was managed conservatively. IJCRI publishes Conclusion:While going through literature we observed that there were no case reports of gangrene caused by scrub typhus. Pan-digital gangrene is an unusual complication of scrub typhus. Hence scrub typhus has to be ruled out in patients presenting with this complication.

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Section: Discussionmentioning

confidence: 99%

Isolated neurocutaneous peripheral T cell lymphoma, NOS

Lakshmanan¹,

Seetharaman²,

Sr³

et al. 2015

IJCRI

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“…Meninges is vulnerable for Orientia tsutsugamushi when compared with other rickettsial infections. The bacteria are found to parasitize endothelial cells in brain causing parenchymal lesions [14]. However, focal CNS damage is rare.…”

Section: Scrub Typhus and Cns Involvementmentioning

confidence: 99%

Severe Condition of Scrub Typhus Meningo-Encephalitis in a Child:A Case Report from Delhi, India

Sharma¹,

Malik²,

Gupta³

et al. 2014

CMRA

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Intracellular parasites are the causative organism of Rickettsial diseases which are pathophysiologically associated with vascular endothelium and reticuloendothelial cells. Scrub typhus is one of the rickettsial infections, where fever is a common symptom. Apart from this, non specific constitutional symptoms and sometimes organ based deterioration including CNS has also been observed. There are reports of scrub typhus with CNS complication like meningoencephalitis in adolescent and adults from various parts of India but not from Delhi. Recently few cases of scrub typhus in adults were reported from Delhi without involvement of CNS. Its occurrence as severe case of hemorrhagic fever with meningo-encephalitis is rarer in children and not so far reported from state of Delhi. We present a case of 4 year old female child from Delhi presenting with scrub typhus meningo-encephalitis, whose timely diagnosis and management saved her life and make us notice the emergence of meningoencephalitic like picture in children in Delhi.

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“…Development of regional lymphadenopathy suggests lymphogenous spread [21]. Subsequently, hematogenously disseminated infection is postulated due to key involvement of endothelial cells and macrophages, both of which release soluble cell-specific adhesion molecules [22]. Although, the exact mechanism of vascular damage caused by O. tsutsugamushi infection remains poorly understood, the primary event might be the destruction of endothelial cells lining small blood vessels and the accompanying inflammatory responses [23,24].…”

Section: Cellular Tropism Is the Key To Dissemination And Pathogenesismentioning

confidence: 99%