Tsutsugamushi disease caused by Shimokoshi-type Orientia tsutsugamushi: the first report in Western Japan.
Tsutsugamushi disease caused by Shimokoshi-type Orientia tsutsugamushi: the first report in Western Japan.
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DOI：
10.4269/ajtmh.12-0740
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发表时间：
2013-06
期刊：
影响因子：
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通讯作者：
S. Ikegaya;H. Iwasaki;N. Takada;Seigo Yamamoto;T. Ueda
中科院分区：
文献类型：
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作者：
S. Ikegaya;H. Iwasaki;N. Takada;Seigo Yamamoto;T. Ueda
一位85岁的女性农民因发热、全身乏力和皮疹入住我院。头孢菌素无效，米诺环素有效。退烧后，在她的腹股沟区发现了一个焦痂。发病12天后对血清进行实验室检查，发现抗恙虫病东方体Shimokoshi株抗体滴度升高。通过巢式聚合酶链反应对患者焦痂标本的基因序列分析显示与Shimokoshi菌株具有高度相似性。因此，该患者被诊断为Shimokoshi型恙虫病病例，此前在日本西部尚未报告。最近，在日本东北部也确认了这类病例，这表明需要进一步进行流行病学研究。
An 85-year-old female farmer was admitted to our hospital for fever, general fatigue, and skin rash. Cephalosporin was not effective and minocycline was dramatically effective. An eschar was discovered on her inguinal region after the defervescence. Laboratory examination of serum taken 12 days after onset of the illness showed elevated titers of antibodies against the Shimokoshi strain of Orientia tsutsugamushi. The gene sequence analysis of specimen from the patient's eschar revealed high similarity to the Shimokoshi strain by nested polymerase chain reaction. Therefore, this patient was diagnosed as a case of Shimokoshi-type tsutsugamushi disease, which has not previously been reported in Western Japan. Recently, cases of this type have also been confirmed in northeastern Japan, suggesting the need for further epidemiological studies.