Pathology of Rickettsia tsutsugamushi Infection in Bandicota savilei, a Natural Host in Thailand

Strickman, Daniel; Smith, Conley; Corcoran, K.; Ngampochjana, Montip; Watcharapichat, Pochaman; Phulsuksombati, Duangporn; Tanskul, Panita; Dasch, Gregory A.; Kelly, Daryl J.

doi:10.4269/ajtmh.1994.51.416

Cited by 24 publications

(17 citation statements)

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“…A major and serious pathologic change of scrub typhus is a focal or disseminated vasculitis due to the destruction of endothelial cell lining of the small vessels, which is manifested as perivascular infiltration of leukocytes [17-19], an increased vascular permeability with extravascular protein loss, and consequently the hypoalbuminemia.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

et al. 2010

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BackgroundThis study was designed to investigate the clinical significance of hypoalbuminemia as a marker of severity and mortality in patients with Scrub typhus.MethodsThe patients with scrub typhus were divided into two groups based on the serum albumin levels; Group I (serum albumin <3.0 g/dL) and Group II (serum albumin ≥3.0 g/dL). The outcome of patients with hypoalbuminemia was compared with that of normoalbuminemia.ResultsOf the total 246 patients who underwent the study, 84 patients (34.1%) were categorized as Group I and 162 patients were (65.9%) as Group II. Group I showed significantly higher incidence of confusion (24.6% vs. 5.3%, p < 0.001), pulmonary edema (15.8% vs. 3.2%, p = 0.002), pleural effusion (22.8% vs. 11.1%, p = 0.03), arrhythmia (12.3% vs. 2.6%, p = 0.008) and non-oliguric acute renal failure (40.4% vs. 11.1%, p < 0.001) compared to group II. Hypoalbuminemic group had a higher APACHE II score (11.37 ± 5.0 vs. 6.94 ± 4.2, p < 0.001), longer hospital stay (19.9 ± 42.1 days vs 7.5 ± 13.8 days, p = 0.012), and higher hospital cost compared to Group II.ConclusionsThis study showed hypoalbuminemia in scrub typhus was closely related to the frequency of various complication, longer hospital stay, consequently the higher medical cost, necessitating more efficient management of patients, including medical resources.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

et al. 2010

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“…Such microangiopathies may involve lung (interstitial pneumonia, IP), cardiovascular system (hypotension and myocarditis), brain (meningoencephalitis), kidney (acute renal failure), gastrointestinal tract (gastrointestinal bleeding), liver (hepatic dysfunction and hepatomegaly), spleen (splenomegaly) and lymph node (lymphadenopathy) (1, 4, 6, 8-10). …”

Section: Introductionmentioning

confidence: 99%

Clinical Role of Interstitial Pneumonia in Patients with Scrub Typhus: A Possible Marker of Disease Severity

Song

Kim

et al. 2004

J Korean Med Sci

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Interstitial pneumonia (IP) frequently occurs in patients with scrub typhus, but its clinical significance is not well known. This study was designed to evaluate interstitial pneumonia as a marker of severity of the disease for patients with scrub typhus. We investigated clinical parameters representing the severity of the disease, and the chest radiographic findings for 101 patients with scrub typhus. We then compared these clinical factors between patients with and without IP. We also studied the relationship between IP and other chest radiographic findings. The chest radiography showed IP (51.4%), pleural effusion (42.6%), cardiomegaly (14.9%), pulmonary alveolar edema (20.8%), hilar lymphadenopathy (13.8%) and focal atelectasis (11.8%), respectively. The patients with IP (n=52) had higher incidences in episode of hypoxia (p=0.030), hypotension (p=0.024), severe thrombocytopenia (p=0.036) and hypoalbuminemia (p=0.013) than the patients without IP (n=49). The patients with IP also had higher incidences of pleural effusion (p<0.001), focal atelectasis (p=0.019), cardiomegaly (p<0.001), pulmonary alveolar edema (p=0.011) and hilar lymphadenopathy (p<0.001) than the patients without IP. Our data suggest that IP frequently occurs for patients with scrub typhus and its presence is closely associated with the disease severity of scrub typhus.

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“…12,24,25 For example, O. tsutsugamushi was isolated up to eight weeks after attachment of a single infected L. deliense larva on R. rattus. 26 Differences (16) in infection rates among the different species of mammals could reflect differences in the course of infection as observed by Strickman and others 23 with B. savilei. Alternatively, the site at which the mammals were collected could affect infection rates.…”

Section: Discussionmentioning

confidence: 98%

“…Although we did not determine chigger infection rates, these data suggest that infection rates in the different species of mammals may be independent of chigger densities. Strickman and others 23 reported that B. savilei mounts a vigorous immune response that limits the infection in this species to no more than 2−3 weeks. In contrast, many Rattus species maintain O. tsutsugamushi infections for months or longer.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Orientia Tsutsugamushi in Small Mammals From Thailand

Coleman¹,

Monkanna²,

Linthicum³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Abstract. Extensive sampling of small mammals was conducted in eight provinces of Thailand between September 9, 1992 and April 29, 2001. A total of 3,498 specimens representing 22 species were collected. Eighty-eight percent (3,089 of 3,498) of the animals were collected from a region in Chiangrai Province, which is commonly recognized as endemic for human scrub typhus. Blood and tissue samples from each animal were tested for the presence of Orientia tsutsugamushi, the etiologic agent of scrub typhus. The predominant species collected were Rattus rattus (53%, n ‫ס‬ 1,863), R. losea (18%, n ‫ס‬ 638), Bandicota indica (16%, n ‫ס‬ 564), and R. exulans (4%, n ‫ס‬ 146). Orientia tsutsugamushi was detected in 10 of the 22 species of mammals that included R. bukit (25% infected, 1 of 4), R. rattus (23%, 419 of 1,855), R. argentiventer (22%, 5 of 23), R. berdmorei (22%, 2 of 9), R. losea (13%, 82 of 638), B. indica (

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Pathology of Rickettsia tsutsugamushi Infection in Bandicota savilei, a Natural Host in Thailand

Cited by 24 publications

References 0 publications

Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

Clinical Role of Interstitial Pneumonia in Patients with Scrub Typhus: A Possible Marker of Disease Severity

Occurrence of Orientia Tsutsugamushi in Small Mammals From Thailand

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