Acute respiratory distress syndrome associated with scrub typhus: diffuse alveolar damage without pulmonary vasculitis.
10.3346/jkms.2000.15.3.343
- Author:
Jae Seuk PARK
1
;
Young Koo JEE
;
Kye Young LEE
;
Keun Yeol KIM
;
Na Hye MYONG
;
Pil Weon SEO
Author Information
1. Department of Internal Medicine, College of Medicine, Dankook University, Cheonan, Korea. jspark@anseo.dankook.ac.kr
- Publication Type:Case Report
- Keywords:
Scrub Typhus;
Respiratory Distress Syndrome;
Adult
- MeSH:
Acute Disease;
Aged;
Case Report;
Fatal Outcome;
Female;
Human;
Infant, Newborn;
Pulmonary Alveoli/pathology;
Pulmonary Alveoli/injuries;
Respiratory Distress Syndrome/physiopathology;
Respiratory Distress Syndrome/pathology;
Respiratory Distress Syndrome/immunology;
Respiratory Distress Syndrome/complications*;
Scrub Typhus/physiopathology;
Scrub Typhus/pathology;
Scrub Typhus/immunology;
Scrub Typhus/complications*;
Vasculitis
- From:Journal of Korean Medical Science
2000;15(3):343-345
- CountryRepublic of Korea
- Language:English
-
Abstract:
Pathologic findings of scrub typhus have been characterized by vasculitis of the microvasculature of the involved organ resulting from a direct invasion by Orientia tsutsugamushi. We experienced a case of acute respiratory distress syndrome (ARDS) associated with scrub typhus. The case was proven by eschar and high titer of serum IgM antibody (positive at 1:1280). Open lung biopsy showed diffuse alveolar damage (DAD) in the organizing stage without evidence of vasculitis. Immunofluorescent antibody staining and polymerase chain reaction for O. tsutsugamushi failed to demonstrate the organism in the lung tissue. The patient expired due to progressive respiratory failure despite doxycycline therapy. Immunologic mechanism, without direct invasion of the organism, may participate in the pathogenesis of ARDS associated with scrub typhus.
