Severe Japanese Spotted Fever Complicated by Acute Respiratory Failure in Kobe City

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  • TAKIGUCHI Junji
    Department of Respiratory Medicine, Kobe Rosai Hospital,
  • OKIMURA Kenjiro
    Department of Orthopedic Surgery, Kobe Rosai Hospital
  • ISHI Mariko
    Department of Respiratory Medicine, Kobe Rosai Hospital,
  • OKAMURA Kayoko
    Department of Respiratory Medicine, Akashi Medical Center
  • SAKAMOTO Hirokazu
    Department of Respiratory Medicine, Kobe Rosai Hospital,
  • INAMOTO Shinya
    Department of Internal Medicine, Kobe Rosai Hospital
  • ANDO Shuji
    <sup> </sup>(Laboratory of Rickettsia and Chlamydia), Department of Virology-1, National Institute of Infectious Diseases

Bibliographic Information

Other Title
  • 神戸市内で発生し呼吸不全を伴った重症日本紅斑熱の1 例
  • 症例 神戸市内で発生し呼吸不全を伴った重症日本紅斑熱の1例
  • ショウレイ コウベ シナイ デ ハッセイ シ コキュウ フゼン オ トモナッタ ジュウショウ ニホンコウ ハン ネツ ノ 1レイ

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Abstract

We report herein on a case of severe Japanese spotted fever complicated by acute respiratory failure in Kobe City. A 70-year-old female presenting with general malaise and systematic erythema was admitted to our hospital in June, 2013. From her history and physical examination, she was found to be suffering from scleroderma and mild interstitial pneumonia. From admission, the patient was noted to have a fever of 39℃ accompanied by relative bradycardia. Physical examination revealed a black eschar on her right leg, making us suspect rickettsial infection since Kobe City is not an area predisposed to Japanese spotted fever. Three days after admission, her condition worsened and treatment with minocycline and levofloxacin was initiated in accordance with the treatment protocol for Japanese spotted fever. The following day, the patient developed acute respiratory distress syndrome (ARDS) and was put on a respirator. She gradually recovered with the antibiotic treatment and was discharged from the hospital 23 days after admission. The diagnosis of Japanese spotted fever was confirmed by conducting a polymerase chain reaction test on the eschar. Japanese spotted fever is noted to occur in any place other than Kobe City. Late diagnoses may result in aggravated cases of Japanese spotted fever, with the possibility of developing ARDS as a complication.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 90 (2), 120-124, 2016

    The Japanese Association for Infectious Diseases

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