title: A case of Japanese spotted fever complicated with central nervous system involvement and multiple organ failure.
abstract: Japanese spotted fever (JSF), first reported in 1984, is a rickettsial disease characterized by high fever, rash, and eschar formation. A 61-year-old man was admitted to a local hospital in Nagasaki City, Japan, after several days of high fever and generalized skin erythema. His condition deteriorated and laboratory findings indicated disseminated intravascular coagulation (DIC). The patient was transferred to our hospital with mental disturbance and status epilepticus. Treatment included minocycline, and new quinolone. Definitive diagnosis was made with a serological test showing increased antibody levels against Rickettsia japonica. Rickettsial infections are rare, but should be seriously considered for the differential diagnosis of aseptic meningitis and encephalitis, as they show no response to conventional antibiotic treatment.
authors.affiliation: The First Department of Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan. koyupa@hotmail.com
authors.forename: Ruka
authors.initials: R
authors.lastname: Nakata
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Motomura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tokuda
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Tomoko
authors.initials: T
authors.lastname: Masuda
authors.forename: Taku
authors.initials: T
authors.lastname: Fukuda
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujino
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D007564:Japan; D008297:Male; D008590:Meningoencephalitis / Q000209:etiology*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D012282:Rickettsia Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012698:Serologic Tests
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial