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Imported scrub typhus: first case in South America and review of the literature
BACKGROUND: Scrub typhus is a neglected vector-borne zoonosis causing life-threatening illnesses, endemic in the Asian-Pacific region and, as recently discovered, in southern Chile. Scrub typhus is rarely reported in travelers, most probably due to the lack of clinical experience and diagnostic test...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097283/ https://www.ncbi.nlm.nih.gov/pubmed/30140442 http://dx.doi.org/10.1186/s40794-018-0070-8 |
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author | Weitzel, Thomas Aylwin, Mabel Martínez-Valdebenito, Constanza Jiang, Ju Munita, Jose Manuel Thompson, Luis Abarca, Katia Richards, Allen L. |
author_facet | Weitzel, Thomas Aylwin, Mabel Martínez-Valdebenito, Constanza Jiang, Ju Munita, Jose Manuel Thompson, Luis Abarca, Katia Richards, Allen L. |
author_sort | Weitzel, Thomas |
collection | PubMed |
description | BACKGROUND: Scrub typhus is a neglected vector-borne zoonosis causing life-threatening illnesses, endemic in the Asian-Pacific region and, as recently discovered, in southern Chile. Scrub typhus is rarely reported in travelers, most probably due to the lack of clinical experience and diagnostic tests in non-endemic countries. We report the first case of imported scrub typhus in South America. CASE PRESENTATION: A 62-year-old tourist from South Korea presented severely ill with fever, rash, and eschar in Santiago, Chile. Laboratory exams showed thrombocytopenia and elevated inflammation parameters, hepatic enzymes, and LDH. With the clinical suspicion of scrub typhus, empirical treatment with doxycycline was initiated and the patient recovered rapidly and without complications. The diagnosis was confirmed by IgM serology and by real-time PCR, which demonstrated infection with Orientia tsutsugamushi (Kawasaki clade). CONCLUSIONS: Only due to the emerging clinical experience with endemic South American scrub typhus and the recent implementation of appropriate diagnostic techniques in Chile, were we able to firstly identify and adequately manage a severe case of imported scrub typhus in South America. Physicians attending febrile travelers need to be aware of this rickettsiosis, since it requires prompt treatment with doxycycline to avoid complications. |
format | Online Article Text |
id | pubmed-6097283 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60972832018-08-23 Imported scrub typhus: first case in South America and review of the literature Weitzel, Thomas Aylwin, Mabel Martínez-Valdebenito, Constanza Jiang, Ju Munita, Jose Manuel Thompson, Luis Abarca, Katia Richards, Allen L. Trop Dis Travel Med Vaccines Case Report BACKGROUND: Scrub typhus is a neglected vector-borne zoonosis causing life-threatening illnesses, endemic in the Asian-Pacific region and, as recently discovered, in southern Chile. Scrub typhus is rarely reported in travelers, most probably due to the lack of clinical experience and diagnostic tests in non-endemic countries. We report the first case of imported scrub typhus in South America. CASE PRESENTATION: A 62-year-old tourist from South Korea presented severely ill with fever, rash, and eschar in Santiago, Chile. Laboratory exams showed thrombocytopenia and elevated inflammation parameters, hepatic enzymes, and LDH. With the clinical suspicion of scrub typhus, empirical treatment with doxycycline was initiated and the patient recovered rapidly and without complications. The diagnosis was confirmed by IgM serology and by real-time PCR, which demonstrated infection with Orientia tsutsugamushi (Kawasaki clade). CONCLUSIONS: Only due to the emerging clinical experience with endemic South American scrub typhus and the recent implementation of appropriate diagnostic techniques in Chile, were we able to firstly identify and adequately manage a severe case of imported scrub typhus in South America. Physicians attending febrile travelers need to be aware of this rickettsiosis, since it requires prompt treatment with doxycycline to avoid complications. BioMed Central 2018-08-16 /pmc/articles/PMC6097283/ /pubmed/30140442 http://dx.doi.org/10.1186/s40794-018-0070-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Weitzel, Thomas Aylwin, Mabel Martínez-Valdebenito, Constanza Jiang, Ju Munita, Jose Manuel Thompson, Luis Abarca, Katia Richards, Allen L. Imported scrub typhus: first case in South America and review of the literature |
title | Imported scrub typhus: first case in South America and review of the literature |
title_full | Imported scrub typhus: first case in South America and review of the literature |
title_fullStr | Imported scrub typhus: first case in South America and review of the literature |
title_full_unstemmed | Imported scrub typhus: first case in South America and review of the literature |
title_short | Imported scrub typhus: first case in South America and review of the literature |
title_sort | imported scrub typhus: first case in south america and review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097283/ https://www.ncbi.nlm.nih.gov/pubmed/30140442 http://dx.doi.org/10.1186/s40794-018-0070-8 |
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