여름에 발생한 혈구탐식림프조직구증을 동반한 중증쯔쯔가무시병 1예 = Severe Scrub Typhus with Hemophagocytic Lymphohistiocytosis Occurring in Summer

국문 초록 (Abstract)

쯔쯔가무시병은 가을철에 호발하는 열성 질환이다. 저자들은 여름에 중증패혈증 양상을 보인 HLH 환자에서 쯔쯔가무시병을 진단하였으며, doxycycline으로 치료 후 호전을 보인 예를 경험하여 이를 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

In Korea, scrub typhus usually occurs in October and November. Hemophagocytic lymphohistiocytosis (HLH) is a distinct clinical entity characterized by a high fever, pancytopenia, hepatosplenomegaly, histiocyte proliferation, and hemophagocytosis. We encountered a summertime case of severe scrub typhus presenting as HLH. A 49-year-old female complained of abdominal pain and fever 3 days in duration. On hospital day 3 she was transferred to the intensive care unit because of clinical deterioration accompanied by severe sepsis. As an eschar was evident on the right shoulder, we commenced doxycycline. Her condition improved dramatically and she was discharged on day 14. Although the indirect immunofluorescence antibody test (IFA) for Orientia tsutsugamushi was negative on admission, a repeat IFA test was positive; the antibody titer was 1:5,120 on hospital day 10. Scrub typhus should be considered during differential diagnosis in a patient with severe sepsis in any season except the fall. (Korean J Med 2017;92:321-325)

참고문헌 (Reference)

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