Scrub typhus hepatitis confirmed by immunohistochemical staining  

作　　者：Jong-Hoon Chung Sung-Chul Lim Na-Ra Yun Sung-Heui Shin Choon-Mee Kim Dong-Min Kim 

机构地区：[1]Department of Internal Medicine,Chosun University College of Medicine,Gwangju 501-717,South Korea [2]Research Center for Resistant Cells,Chosun University,Gwangju 501-717,South Korea [3]Department of Pathology,Chosun University College of Medicine,Gwangju 501-717,South Korea [4]Department of Microbiology,Chosun University College of Medicine,Gwangju 501-717,South Korea

出　　处：《World Journal of Gastroenterology》2012年第36期5138-5141,共4页世界胃肠病学杂志（英文版）

基　　金：Supported by The Korea Science and Engineering Foundation Grant Funded by the Korean Government through the Research Center for Resistant Cells, No. R13-2003-009

摘　　要：Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by his- topathological examination of liver biopsy specimens, serological tests and nested polymerase chain reaction. Immunohistochemical staining using a monoclonal an- ti-O. tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes. This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis. Thus, scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses, which causes severe Iobular disarray with diffuse hepatocytic degeneration, necrosis and apoptosis as well as findings indicative of hepatic cholestasis, such as hepatic bile plugs or brown pigmentation of hepatocytes.Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi(O.tsutsugamushi).We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by histopathological examination of liver biopsy specimens,serological tests and nested polymerase chain reaction.Immunohistochemical staining using a monoclonal anti-O.tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes.This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis.Thus,scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses,which causes severe lobular disarray with diffuse hepatocytic degeneration,necrosis and apoptosis as well as findings indicative of hepatic cholestasis,such as hepatic bile plugs or brown pigmentation of hepatocytes.

关 键 词：Scrub typhus  Immunohistochemistry Ori-entia tsutsugamushi 

分 类 号：R513.2[医药卫生—内科学]