title: Japanese spotted fever with acute hepatic failure: was it associated with Epstein-Barr virus?
abstract: BACKGROUND
  An 81-year-old female experiencing high fever, fatigue, and loss of appetite was admitted to our hospital and diagnosed with acute cholecystitis. Her condition did not improve and an eschar and erythema subsequently appeared. We then diagnosed Japanese spotted fever (JSF). She recovered immediately after the administration of minocycline. This case differed from other cases because the patient had a remarkably acute hepatic failure.
  
  
  METHODS
  Considering that the present case might be associated with other factors, we performed a repeat polymerase chain reaction (PCR) test on the patient's blood that had been collected on admission and stored.
  
  
  RESULTS
  Epstein-Barr virus (EBV) was detected in her blood by PCR.
  
  
  CONCLUSIONS
  We consider this case might be associated with EBV.
authors.affiliation: Department of Dermatology, Ise Municipal General Hospital, Ise, Mie, Japan. pjskt886@ybb.ne.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Kondo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kurokawa
authors.forename: Kei-ichi
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Akachi
authors.forename: Masami
authors.initials: M
authors.lastname: Nishii
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002438:Cefoperazone / Q000627:therapeutic use; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000188:drug therapy; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000382:microbiology* / Q000821:virology*; D008911:Minocycline / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D012281:Rickettsia / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D013407:Sulbactam / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002438:Cefoperazone; D008911:Minocycline; D013407:Sulbactam