Kosin Medical Journal

Case reports

Scrub typhus infection in a kidney transplant recipient: a case report: Dongyeon Lee, Joohee Jeon, Jae Sung Ahn, Chung Hee Baek; Kosin Med J. 2023;38(3):224-228. Published online June 9, 2023; DOI: https://doi.org/10.7180/kmj.23.114

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Abstract PDF PubReader ePub: Scrub typhus is a febrile disease that is endemic to Asia and the Pacific region. Its clinical manifestations include fever, myalgia, lymphadenopathy, and a characteristic eschar. The main manifestations of this disease are difficult to differentiate from those of other febrile illnesses; thus, a careful clinical examination and a high index of suspicion are crucial for an early diagnosis. Our case involved a 55-year-old female renal transplant recipient who presented with fever and sore throat in November. Her clinical symptoms did not improve after oral amoxicillin/clavulanate administration for 7 days, after which proteinuria and acute kidney injury were identified. After hospitalization, an eschar was found and immunoglobulin M antibodies against Orientia tsutsugamushi were detected by indirect immunofluorescence. She received oral doxycycline for 7 days and showed improvement in renal function and proteinuria. This is the first case report of scrub typhus infection in a kidney transplant patient in Korea. It is meaningful to report that the renal abnormalities associated with scrub typhus improved in a renal transplant patient through treatment of the disease. This case highlights the importance of examining the social history and symptoms of patients suspected of having scrub typhus in endemic areas. Early diagnosis and treatment are crucial in kidney transplant patients to preserve graft function and prevent fatal complications.

Scrub typhus with complications of acute myocarditis and cardiac tamponade in metropolitan areas: two case reports: Ki-Woon Kang, Wonho Kim; Kosin Med J. 2023;38(3):210-214. Published online June 9, 2023; DOI: https://doi.org/10.7180/kmj.23.111

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Scrub typhus is known as one of the most common seasonal infections in endemic rural areas, but life-threatening cardiac complications in cases of scrub typhus are very infrequent. In addition, scrub typhus infection has been rarely reported among workers assembling pallets using manufactured wood in metropolitan areas. Herein, we present two cases involving myocarditis and cardiac tamponade as complications of scrub typhus. One patient died and the other patient survived. These cases indicate that scrub typhus infection could be an environmental hazard in metropolitan areas, especially in locations with poor hygiene, and highlight the need for timely diagnosis and proper management of severe scrub typhus infections. Therefore, we present these two informative fatal cases of scrub typhus infection presenting with myocarditis and cardiac tamponade as an environmental hazard in metropolitan areas.

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Diagnosis of a Rare Rickettsia felis Infection Complicated with Unusual Pericardial Effusion and Cardiac Tamponade Using an mNGS Test
Tien-Lung Po, Chien-Hsien Huang, Chia-Hsun Lin, Huei-Fong Hung, Piyush Baindara
Case Reports in Infectious Diseases.2024;[Epub] CrossRef

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