A case report of scrub typhus complicated with myocarditis and rhabdomyolysis

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Abstract

Background

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, a gram-negative intracellular bacterium. Myocarditis and rhabdomyolysis are rare complications of scrub typhus.

Case presentation

We report a case of scrub typhus, which was simultaneously complicated with myocarditis and rhabdomyolysis. A 54-year-old woman presented to our hospital with myalgia in the upper and lower limbs, oedema and a fever of 7 days’ duration. We confirmed the diagnosis of scrub typhus complicated with myocarditis by pericardial fluid analysis and cardiac magnetic resonance imaging results. The pericardial fluid showed characteristics of an exudate, an elevated immunofluorescence assay (IFA) IgG titer of 1:2048 and a positive 16S rRNA qPCR result. We also diagnosed rhabdomyolysis by the patient’s presenting symptoms, elevated muscle enzyme levels and bone scan results.

Conclusion

We report for the first time a case of scrub typhus complicated with both myocarditis and rhabdomyolysis, the causative agent of which was the Boryong genotype of O. tsutsugamushi.

Related collections

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Author and article information

Contributors

Young-Jae Ki: bigpapi0427@chosun.ac.kr

Dong-Min Kim:

ORCID: http://orcid.org/0000-0001-6373-0922

82-62-220-3108 , drongkim@chosun.ac.kr

Na-Ra Yoon: shine@chosun.ac.kr

Sung-Soo Kim: kholywater@chosun.ac.kr

Choon-Mee Kim: choonmee@chosun.ac.kr

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect. Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 7 November 2018

Publication date PMC-release: 7 November 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 551

Affiliations

[1 ]ISNI 0000 0000 9475 8840, GRID grid.254187.d, Departments of Internal Medicine, , College of Medicine, Chosun University, ; 588 Seosuk-dong, Dong-gu, Gwangju, 61453 Republic of Korea

[2 ]ISNI 0000 0000 9475 8840, GRID grid.254187.d, Premedical Science, College of Medicine, , Chosun University, ; Gwangju, Republic of Korea

Author information

Dong-Min Kim http://orcid.org/0000-0001-6373-0922

Article

Publisher ID: 3458

DOI: 10.1186/s12879-018-3458-1

PMC ID: 6223005

PubMed ID: 30404620

SO-VID: ef989c3b-4cab-4377-8032-47eb899d46d6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.