title: Afebrile scrub typhus (Tsutsugamushi disease) with acute respiratory distress syndrome.
abstract: A 74-year-old Japanese man with scrub typhus presented without the typical symptom of high fever and subsequently developed the complication of acute respiratory distress syndrome. It was suspected that exposure occurred at the river side of Kinugawa, Tochigi Prefecture, Japan. His body temperature was below 38.0 degrees C. After intensive supportive care and minocycline therapy, he dramatically recovered. With the increase in popularity of outdoor recreation, scrub typhus can be found in clinics all over Japan. Physicians should therefore be aware of the manifestations of the disease and the necessity of early treatment in suspected cases.
authors.affiliation: Department of Internal Medicine, Saiseikai Utsunomiya Hospital.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ichimura
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Uchida
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Arai
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Sasaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Kuni
authors.initials: K
authors.lastname: Iwai
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kubo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001831:Body Temperature; D006801:Humans; D008297:Male; D008911:Minocycline / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline