A Case of Japanese Spotted Fever Complicated with Respiratory Failure and DIC

NIIHARA Hiroyuki, MIZUMOTO Kazuo, MORITA Eishin, TAOOKA Yasuyuki, TABARA Kenji

doi:10.2336/nishinihonhifu.72.220

We report a case of Japanese spotted fever complicated with respiratory failure and disseminated intravascular coagulatino (DIC). A 65-year-old Japanese female had fever, headache, backache, and joint pain in all four extremities 5 days before her first medical examination. As general fatigue and nausea also developed, she visited the Emergency Department in our University Hospital and was referred to our department. A diagnosis of atypical measles was suspected because of high fever and rice grain-sized erythematous papules scattered on her whole body. After several days she experienced respiratory failure. Her blood examination showed leukocytosis and DIC, and a computed tomography image of her chest revealed pneumonia. A diagnosis of adult respiratory distress syndrome (ARDS) caused by infection was made, and systemic corticosteroid-and immunoglobulin-therapy was started in addition to cephalosporin and minocyclin. As a result of the combination therapy her symptoms improved rapidly. A PCR analysis detected genomic DNA of Rickettsia japonica in a crust obtained from her back lesions. Antibodies against spotted fever group Rickettsia were markedly increased in a paired serum examination. A final diagnosis of Japanese spotted fever complicated with respiratory failure and DIC was made. Cases of Japanese spotted fever are increasing in recent days, and the disease should be always considered as a differential diagnosis in cases of fever and erythematous rash.

A Case of Japanese Spotted Fever Complicated with Respiratory Failure and DIC

Bibliographic Information

Search this article

Description

Journal

References(14)*help

Keywords

Details 詳細情報について

Export

Report a problem