Granulomatous hepatitis associated with scrub typhus.
A 56 year old patient with scrub typhus infection having unusual presentation of hepatic injury resembling acute hepatitis is described. The clinical features of fever, headache, eschar, lymphadenopathy, lymphocytosis and high Rickettsia tsutsugamushi immunofluorescence titres confirmed the diagnosis of scrub typhus. Acute hepatitis was proven by hepatic biochemical tests and liver biopsy. The patient had a complete recovery soon after antibiotic treatment. The presentation of this case suggests that scrub typhus infection should be included in the list of differential diagnosis of acute hepatitis or granulomatous hepatitis, at least in the Asian Pacific region where scrub typhus still prevails.
Liver Unit, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
R N
RN
Chien
N J
NJ
Liu
P Y
PY
Lin
Y F
YF
Liaw
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006505:Hepatitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008230:Lymphomatoid Granulomatosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012612:Scrub Typhus / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents