Tsutsugamushi-Fieber: Seltene Rickettsiose nach Aufenthalt auf den Philippinen
| العنوان: | Tsutsugamushi-Fieber: Seltene Rickettsiose nach Aufenthalt auf den Philippinen |
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| المؤلفون: | Strauss R, Fischer Bp, Müller A, Schneider Ht, E. G. Hahn |
| المصدر: | DMW - Deutsche Medizinische Wochenschrift. 123:562-566 |
| بيانات النشر: | Georg Thieme Verlag KG, 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | medicine.medical_specialty, biology, business.industry, General Medicine, biology.organism_classification, Gastroenterology, Rash, Pharyngitis, Rickettsia, Cervical lymphadenopathy, Clarithromycin, Internal medicine, medicine, Vomiting, Sputum, Leukocytosis, medicine.symptom, business, medicine.drug |
| الوصف: | HISTORY AND CLINICAL FINDINGS After returning to his native Germany from a holiday in the Philippines a 37-year-old man was admitted because of high fever, cervical lymphadenopathy, pharyngitis and conjunctivitis, transient skin rash, nausea and vomiting, leukocytosis with shift to the left, atypical lymphocytes, as well as increased transaminases, LDH and cholestasis-indicating enzymes. INVESTIGATIONS Stool, sputum and urine cultures were negative. The chest radiogram showed bilateral mild interstitial infiltration. Antibody titres against Rickettsia tsutsugamushi were markedly raised (IgG 1:128, IgM 1:2048). DIAGNOSIS, TREATMENT AND COURSE Empirical antibiotic treatment with ciprofloxacin (200 mg twice daily intravenously) had no effect. As the mild signs of interstitial pneumonia progressed, clarithromycin (500 mg twice daily orally) was substituted with rapid fall in fever and gradual improvement. Tsutsugamushi infection was diagnosed serologically and the antibiotic changed to doxycycline (100 mg twice daily orally), continued for 14 days. Full remission occurred. CONCLUSIONS Tsutsugamushi fever should be included in the differential diagnosis if, in addition to a history of a visit to an endemic area, there is the clinical triad of skin necrosis at the site of a mite bite, regional lymphadenopathy and skin rash (in this case, no skin lesion). The infection can be lethal without adequate treatment. Tetracyclines and possibly also macrolide antibiotics are effective against the causative organism. |
| تدمد: | 1439-4413 0012-0472 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::31589aee52403b1f154a2954efb17278Test https://doi.org/10.1055/s-2007-1024011Test |
| رقم الانضمام: | edsair.doi...........31589aee52403b1f154a2954efb17278 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14394413 00120472 |
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