A Case Report of Scrub Typhus: Secondary Acute Arrest of Hemopoiesis with Multiple Organ Dysfunction Syndromes

Guancheng Song, Ying Song, Yanfang Zhang, Xi Huang, Jianchuan Deng
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Abstract

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi (O. tsutsugamushi) in which humans are accidental hosts. Acute arrest of hemopoiesis (AAH) always manifests in pancytopenia and with supportive treatment or inducement removal, the AAH patients would show significant im-provement in blood routine for about a week. As a rapidly progressive and potentially life-threatening organ function disorder syndrome, multiple organ dysfunction syndrome (MODS) is often induced by many factors including infection, illness and injury. We received a rare case of scrub typhus rapidly presenting with AAH and MODS 2 weeks ago. The clinical data of a 32-year-old female with O. tsutsugamushi-induced AAH and MODS was summarized retrospectively and analyzed with a literature review. In this case, we selected tigecycline and moxifloxacin as treatment regimens for scrub typhus. When the potential infection was controlled, her pancytopenia and hepatic function rapidly improved in a few days.
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恙虫病继发性急性造血停止伴多器官功能障碍综合征1例
恙虫病是一种由恙虫病东方体引起的人畜共患疾病,人类是意外宿主。急性造血停止(Acute arrest of hematopoiesis, AAH)常表现为全血细胞减少,在给予支持治疗或去除诱导后,AAH患者的血常规可在一周左右出现明显改善。多器官功能障碍综合征(MODS)是一种进展迅速且可能危及生命的器官功能障碍综合征,其诱发因素包括感染、疾病和损伤等。2周前,我们收到了一例罕见的恙虫病病例,迅速表现为急性斑疹伤寒和MODS。回顾性总结1例32岁女性恙虫病恙虫病AAH合并MODS的临床资料,并进行文献复习分析。在本病例中,我们选择替加环素和莫西沙星作为治疗恙虫病的方案。当潜在感染得到控制后,她的全血细胞减少症和肝功能在几天内迅速改善。
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