Japanese Spotted Fever

dok_zlo — 05.08.2022

A 68-year-old woman presented to the clinic with a 5-day history of rash, fevers, chills, myalgias, and fatigue. She lived in Japan and had been bitten by a tick on her right ankle 1 week before the onset of symptoms. The rash, which initially had a maculopapular appearance, had erupted abruptly on her arms and legs and had progressed to petechial lesions that also involved the trunk. On examination, the patient’s temperature was 39.2°C. There was a petechial rash on the trunk, arms, legs, palms, and soles (Panels A and B) and an eschar on the right medial ankle (Panel A, inset). She was admitted to the hospital for further evaluation and monitoring. Laboratory studies showed elevated inflammatory markers, a platelet count of 56,000 per cubic millimeter (reference range, 158,000 to 348,000), an alanine aminotransferase level of 98 U per liter (reference range, 10 to 42), and an aspartate aminotransferase level of 165 U per liter (reference range, 13 to 30). Polymerase-chain-reaction testing of a biopsy specimen of the eschar detected Rickettsia japonica. A diagnosis of Japanese spotted fever was made. After the patient completed a 2-week course of minocycline therapy, her symptoms resolved. Kosuke Ishizuka, M.D.Makoto Sugaya, M.D., Ph.D. International University of Health and Welfare Narita Hospital, Narita, Japan August 4, 2022 N Engl J Med 2022; 387:451

Оставить комментарий

Популярные посты:

bafostri

Профориентация в IT: как не ошибиться с выбором профессии

flackelf

По дорога бывшей Восточной Пруссии.

pro100_mica

Память дня, Александр Рагулин

olesya11am

Идиотизм или...?

bor_odin

Волюнтарист Хрущев и художники

dymontiger

Стиль на красной ковровой дорожки CMA Awards

guryshkina

Делюсь рецептом вкусного и не сильно калорийного ужина

catherine_catty

"Советский вечер на Вятской", или Назад, в прошлое

id77

Любопытная география :-)

• Ранее
• Архив