Activation of the coagulation cascade in patients with scrub typhus

被引:10
作者
Lee, Hee-Jeong [1 ]
Park, Chi-Young [1 ]
Park, Sang-Gon [1 ]
Yoon, Na-Ra [1 ]
Kim, Dong-Min [1 ]
Chung, Choon-Hae [1 ]
机构
[1] Chosun Univ Hosp, Dept Internal Med, Gwangju 501717, South Korea
关键词
Scrub typhus; Disseminated intravascular coagulation; Orientia tsutsugamushi; DISSEMINATED INTRAVASCULAR COAGULATION; ORIENTIA-TSUTSUGAMUSHI; MENINGITIS; FAILURE;
D O I
10.1016/j.diagmicrobio.2017.06.011
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
This retrospective study aimed to evaluate the levels of coagulation factors and presence of disseminated intravascular coagulation (DIC) in patients with scrub typhus. We included patients confirmed to have scrub typhus at the Chosun University Hospital between September 2004 and December 2009. The DIC scores were evaluated in 365 patients and 36 healthy controls. The median concentrations of fibrinogen, D-dimer, and fibrin/fibrinogen degradation products (FDP) were compared between patients and healthy controls (p < 0.001 for all tests). Patients with scrub typhus had longer prothrombin time and lower platelet counts than the controls. Major bleeding was observed in 18/365 patients with scrub typhus. Fifty-one (14.0%) patients presented with severe complications of scrub typhus. Overt DIC and thrombocytopenia (<100,000 platelets/mm(3)) were observed more frequently in patients with bleeding and severe illness. Furthermore, median platelet counts were low in both groups. Approximately 2.7% (n = 10) and 16.4% (n = 60) patients with scrub typhus had overt DIC, as defined by the International Society on Thrombosis and Hemostasis DIC score (DICI) and the DIC-scoring template with a fibrinogen/C-reactive protein-ratio (DIC2), respectively. Three (16.7%) and 10 (55.6%) patients with bleeding had overt DIC, as defined by the DIC1 and DIC2, respectively. Seven (13.7%) and 26 (51%) patients with severe illness had overt DIC, as defined by DIC1 and DIC2, respectively. In conclusion, activation of the coagulation system is an important feature of scrub typhus and is correlated with severe disease, including bleeding. THis is the first study to report a relationship between DIC and scrub typhus. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:1 / 6
页数:6
相关论文
共 24 条
[1]  
Ben Ren-Jy, 1999, Journal of Microbiology Immunology and Infection, V32, P57
[2]   Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: A lack of consensus leads to a lot of confusion [J].
Blacksell, Stuart D. ;
Bryant, Naomi J. ;
Paris, Daniel H. ;
Doust, Jenny A. ;
Sakoda, Yoshihiro ;
Day, Nicholas P. J. .
CLINICAL INFECTIOUS DISEASES, 2007, 44 (03) :391-401
[3]  
Chang JH, 2000, SCAND J INFECT DIS, V32, P101, DOI 10.1080/00365540050164344
[4]   Multiple organ failure complicating probable scrub typhus [J].
Cracco, C ;
Delafosse, C ;
Baril, L ;
Lefort, Y ;
Morelot, C ;
Derenne, JP ;
Bricaire, F ;
Similowski, T .
CLINICAL INFECTIOUS DISEASES, 2000, 31 (01) :191-192
[5]  
Hu ML, 2005, AM J TROP MED HYG, V73, P667
[6]  
Izumo Takehiro, 2008, Nihon Kokyuki Gakkai Zasshi, V46, P385
[7]   Dissemination of Orientia tsutsugamushi and Inflammatory Responses in a Murine Model of Scrub Typhus [J].
Keller, Christian A. ;
Hauptmann, Matthias ;
Kolbaum, Julia ;
Gharaibeh, Mohammad ;
Neumann, Melanie ;
Glatzel, Markus ;
Fleischer, Bernhard .
PLOS NEGLECTED TROPICAL DISEASES, 2014, 8 (08)
[8]   Scrub Typhus Meningitis or Meningoencephalitis [J].
Kim, Dong-Min ;
Chung, Jong-Hoon ;
Yun, Na-Ra ;
Kim, Seok Won ;
Lee, Jun-Young ;
Han, Mi Ah ;
Lee, Yong-Bok .
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 2013, 89 (06) :1206-1211
[9]   Utility of the fibrinogen/C-reactive protein ratio for the diagnosis of disseminated intravascular coagulation [J].
Kim, Hyun Kyung ;
Lee, Dong Soon ;
Kang, Seong-Ho ;
Kim, Jin Q. ;
Park, Seonyang ;
Cho, Han-Ik .
ACTA HAEMATOLOGICA, 2007, 117 (01) :34-39
[10]  
Lee S, 2003, CLIN NEPHROL, V60, P59