Imported scrub typhus: first case in South America and review of the literature

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dc.contributor.authorWeitzel, Thomas
dc.contributor.authorMartínez Valdebenito, Constanza Pamela
dc.contributor.authorAbarca Villaseca, Katia
dc.contributor.authorAylwin, Mabel
dc.contributor.authorJiang, Ju
dc.contributor.authorMunita, Jose M.
dc.contributor.authorThompson, Luis
dc.contributor.authorRichards, Allen L.
dc.date.accessioned2019-10-17T13:30:29Z
dc.date.available2019-10-17T13:30:29Z
dc.date.issued2018
dc.date.updated2019-10-14T19:14:26Z
dc.description.abstractAbstract Background Scrub typhus is a neglected vector-borne zoonosis causing life-threatening illnesses, endemic in the Asian-Pacific region and, as recently discovered, in southern Chile. Scrub typhus is rarely reported in travelers, most probably due to the lack of clinical experience and diagnostic tests in non-endemic countries. We report the first case of imported scrub typhus in South America. Case presentation A 62-year-old tourist from South Korea presented severely ill with fever, rash, and eschar in Santiago, Chile. Laboratory exams showed thrombocytopenia and elevated inflammation parameters, hepatic enzymes, and LDH. With the clinical suspicion of scrub typhus, empirical treatment with doxycycline was initiated and the patient recovered rapidly and without complications. The diagnosis was confirmed by IgM serology and by real-time PCR, which demonstrated infection with Orientia tsutsugamushi (Kawasaki clade). Conclusions Only due to the emerging clinical experience with endemic South American scrub typhus and the recent implementation of appropriate diagnostic techniques in Chile, were we able to firstly identify and adequately manage a severe case of imported scrub typhus in South America. Physicians attending febrile travelers need to be aware of this rickettsiosis, since it requires prompt treatment with doxycycline to avoid complications.Abstract Background Scrub typhus is a neglected vector-borne zoonosis causing life-threatening illnesses, endemic in the Asian-Pacific region and, as recently discovered, in southern Chile. Scrub typhus is rarely reported in travelers, most probably due to the lack of clinical experience and diagnostic tests in non-endemic countries. We report the first case of imported scrub typhus in South America. Case presentation A 62-year-old tourist from South Korea presented severely ill with fever, rash, and eschar in Santiago, Chile. Laboratory exams showed thrombocytopenia and elevated inflammation parameters, hepatic enzymes, and LDH. With the clinical suspicion of scrub typhus, empirical treatment with doxycycline was initiated and the patient recovered rapidly and without complications. The diagnosis was confirmed by IgM serology and by real-time PCR, which demonstrated infection with Orientia tsutsugamushi (Kawasaki clade). Conclusions Only due to the emerging clinical experience with endemic South American scrub typhus and the recent implementation of appropriate diagnostic techniques in Chile, were we able to firstly identify and adequately manage a severe case of imported scrub typhus in South America. Physicians attending febrile travelers need to be aware of this rickettsiosis, since it requires prompt treatment with doxycycline to avoid complications.
dc.fuente.origenBiomed Central
dc.identifier.citationTropical Diseases, Travel Medicine and Vaccines. 2018 Aug 16;4(1):10
dc.identifier.doi10.1186/s40794-018-0070-8
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26628
dc.issue.numeroNo. 10
dc.language.isoen
dc.pagina.final5
dc.pagina.inicio1
dc.revistaTropical Diseases, Travel Medicine and Vaccines volumees_ES
dc.rights.holderThe Author(s).
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.otherTifus epidémico transmitido por piojos - Chile -Casos clínicoses_ES
dc.subject.otherEnfermedades transmisibles en animaleses_ES
dc.subject.otherEnfermedades infecciosases_ES
dc.subject.otherZoonosises_ES
dc.titleImported scrub typhus: first case in South America and review of the literaturees_ES
dc.typeartículo
dc.volumenVol. 4
sipa.codpersvinculados70281
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