title: Autopsy case of acute liver failure due to scrub typhus.
abstract: Scrub typhus (Tsutsugamushi disease) is an acute febrile disease caused by infection with Orientia tsutsugamushi transmitted by mites. Although patients with scrub typhus commonly display mild liver injury, few die of acute liver failure. We describe herein an autopsy case of acute liver failure due to scrub typhus, which was complicated by disseminated intravascular coagulation and showed rapid progression of liver injury just before death. Histopathological findings revealed submassive hepatocellular necrosis, inflammatory cell infiltration in Glisson's capsules, and sporadic fibrin thrombi in the hepatic sinusoids. Cause of death was primarily associated with acute liver failure related to disseminated intravascular coagulation.
authors.affiliation: Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan. y-shioi@mta.biglobe.ne.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shioi
authors.affiliation: Department of Endoscopy, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Murakami
authors.affiliation: Department of Gastroenterology and Hepatology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takikawa
authors.affiliation: Department of Intensive Care Unit, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Miyate
authors.affiliation: Department of Pathology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Tomichi
authors.affiliation: Department of Pathology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takayama
authors.affiliation: Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Uesugi
authors.affiliation: Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sugai
keywords: Acute liver failure; Disseminated intravascular coagulation (DIC); Massive hepatic necrosis; Scrub typhus (Tsutsugamushi disease)