Elevated Extracellular Levels of Granzymes in Patients with Scrub Typhus.

Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi, which is transmitted through chigger mites. Delayed treatment results in various complications and, in severe cases, death. Granzymes are secreted by cytotoxic T lymphocytes or natural killer cells and are known to play an important role in controlling intracellular pathogens. To date, few studies have been done on granzymes in patients with scrub typhus. In this study, granzymes A and B showed a significant increase during the acute stage of scrub typhus compared with healthy control subjects, and decreased sharply after treatment. In addition, granzymes A and B were significantly high in the moderately elevated liver enzyme group. In conclusion, it appears that the host during the acute phase of scrub typhus increases cytotoxic T-cell activity to control infection.

Marked elevation of serum lipase in scrub typhus without pancreatitis: a report of three cases.

Scrub typhus, a re-emerging acute febrile zoonosis can present as an undifferentiated fever often complicated by potentially fatal systemic involvement. Acute pancreatitis is a rare complication of scrub typhus which can result in a marked elevation of serum lipase. We report three cases of scrub typhus who presented with acute undifferentiated fever, where a marked elevation of serum lipase occurred without any evidence of acute pancreatitis, or other causes of elevated lipase levels. Scrub typhus should be considered as a cause of marked elevation of serum lipase, which can occur in the absence of pancreatitis.

[Peritoneal reaction to infection with tsutsugamushi rickettsia in mice with different sensitivity to the agent]. / Reaktsiia briushiny na zarazhenie rikketsiiami tsutsugamusi u mysheu s raznou chuvstvitel'nost'i k vozbuditeliu

Infection of white random-bred mice and C57B1(6) mice with a culture of R. tsutsugamushi demonstrated that white mice were highly susceptible to the infection which ended in death of the animals and accumulation of rickettsia in the body and necrotization of cell elements of the exudate. Mice of C57B1(6) strain developed acymptomatic infection, rickettsia did not multiply in the peritoneal cavity and exudate cells did not undergo necribiosis. The mechanism of resistance of cells of these mice to the agent requires a further study.

Cytological investigation of Rickettsia tsutsugamushi infection of mice with different allotypic susceptibility to the agent.

Cytological and cytochemical studies on Swiss and random-bred white mice susceptible to Rickettsia tsutsugamushi infection as well as resistant C57 Black 6 and CBA mice revealed a clear-cut relationship between the severity of infection and the pattern of macrophage reaction. In highly susceptible mice the fatal infection was accompanied by death of macrophages and necrotisation of the peritoneal exudate cells. The resistant mice showed no clinical signs but developed an intensive macrophage reaction, and the main mass of the inoculated rickettsiae died at the inoculation site, the macrophages remaining viable. Phagocytosis and digestion of rickettsiae were accompanied by markedly increased activities of hydrolytic and oxidizing-reducing enzymes.