Severe Japanese Spotted Fever Successfully Treated with Fluoroquinolone

Abstract

Abstract

Significantly Higher Cytokine and Chemokine Levels in Patients with Japanese Spotted Fever than in Those with Tsutsugamushi Disease

“…It is generally said that the clinical course of JSF is worse than that of TD despite antibiotic treatment, and in cases of severe JSF with complications where monotherapy with either minocycline or doxycycline was not effective, such patients can be successfully treated using tetracyclines combined with quinolones (ciprofloxacin, levofloxacin, etc.) (32). However, in this study, although we examined correlations between the severity of JSF and some cytokine levels, we could not show any significant difference.…”

Nine cases of Japan spotted fever diagnosed at our hospital in 2008

“…DIC may occur if the diagnosis of R. japonica infection might be delayed 5,6 . It has been suggested that patients with more than 6 d after onset of JSF may suffer from DIC complication 4 …”

“…About 700 cases of JSF have been reported so far in Japan; most cases of JSF have been reported along the Pacific coast 2 . The patients with JSF are generally treated with minocycline, 2 doxycycline, 2 and sometimes with fluoroquinolone 4 . One of the severest complications is disseminated intravascular coagulation (DIC), which may occur if the disease progresses or the diagnosis of JSF is delayed 5 .…”

A Case of Japanese Spotted Fever Complicated with Central Nervous System Involvement and Multiple Organ Failure

“…Although it required 11 days to initiate the appropriate treatment with tetracycline in the present case, the patient responded well and recovered from DIC and MOF. Combination therapy using new quinolone and minocycline is recommended for more severe cases (14,15). It is advisable to consider the combination therapy, as our patient showed favorable response to new quinolone which was added for the prolonged low grade fever.…”