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Southeast Asian J Trop Med Public Health ; 2002 Dec; 33(4): 780-6
Artigo em Inglês | IMSEAR | ID: sea-36150

RESUMO

Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.


Assuntos
Adulto , Idoso , Animais , Vetores Aracnídeos/microbiologia , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Coagulação Intravascular Disseminada/microbiologia , Dispneia/microbiologia , Doenças Endêmicas/estatística & dados numéricos , Feminino , Febre/microbiologia , Cefaleia/microbiologia , Hematócrito , Hospitalização/estatística & dados numéricos , Humanos , Hipoalbuminemia/microbiologia , Leucocitose/microbiologia , Doenças Linfáticas/microbiologia , Masculino , Pessoa de Meia-Idade , Ácaros/microbiologia , Insuficiência de Múltiplos Órgãos/microbiologia , Estudos Prospectivos , Insuficiência Respiratória/microbiologia , Tifo por Ácaros/sangue , Choque Séptico/sangue , Tailândia/epidemiologia , Trombocitopenia/microbiologia
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