About: Misdiagnosis of scrub typhus complicated by hemophagocytic syndrome

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Misdiagnosis of scrub typhus complicated by hemophagocytic syndrome
Creator	Zheng, Xiang Ge, Lisha He, Shijun Huang, Airong Lin, Miaomiao
Source	PMC
abstract	BACKGROUND: This study sought to analyze the cases of clinical misdiagnosis of scrub typhus complicated by hemophagocytic syndrome. METHODS: We retrospectively reviewed the medical records for diagnoses, clinical course, chest X-ray findings, laboratory data, and antibiotic therapy. RESULTS: All nine patients were misdiagnosed at the outpatient department between 07/2009 and 07/2017. They were diagnosed with septicemia and hemophagocytic syndrome, sepsis and hemophagocytic syndrome, severe infection, hepatitis and hemophagocytic syndrome, or upper respiratory tract infection. Among the nine patients, hepatic function examination showed decreased albumin and elevated C-reactive protein levels in all patients; alanine aminotransferase was increased and platelets were decreased in eight patients. Weil-Felix reaction was positive in three of nine patients. Indirect immunofluorescence demonstrated positive IgM antibody and EB virus-IgM in all nine patients; Mycoplasma pneumoniae antibody was positive in seven patients. All nine patients underwent chest computed tomography; no abnormality was found in two patients. Patch shadow with increased density was found in seven patients, including four patients with right pleural effusion and two with bilateral pleural effusion. Bone marrow biopsy was performed in all nine patients and hemophagocytic cells were seen. The nine misdiagnosed cases were given multiple broad-spectrum antibiotics either successively or concomitantly before and after admission, but no effective antibiotics against Orientis tsutsugamushi were applied. After diagnosis was corrected to scrub typhus, five patients were switched to chloramphenicol and dexamethasone, two patients were given azithromycin and dexamethasone, and two patients were treated with chloramphenicol. Body temperature returned to normal within 2–3 days and the children were quickly relieved from their condition. CONCLUSION: Hemophagocytic syndrome may be the presenting clinical feature of scrub typhus and initially mask the disease. Initial misdiagnosis is common and includes septicemia and hemophagocytic syndrome. The eschar is a useful diagnostic clue and febrile patients without any localizing signs should be thoroughly examined for its presence.
has issue date	2019-04-10(xsd:dateTime)
bibo:doi	10.1186/s12887-019-1475-x
bibo:pmid	30971222
has license	cc-by
sha1sum (hex)	50b6a6d5ea21f3e1b1d2872bcdab95e3646ed400
schema:url	https://doi.org/10.1186/s12887-019-1475-x
resource representing a document's title	Misdiagnosis of scrub typhus complicated by hemophagocytic syndrome
has PubMed Central identifier	PMC6458710
has PubMed identifier	30971222
schema:publication	BMC Pediatr
resource representing a document's body	covid:50b6a6d5ea21f3e1b1d2872bcdab95e3646ed400#body_text
is schema:about of	named entity 'cases' covid:arg/50b6a6d5ea21f3e1b1d2872bcdab95e3646ed400 named entity 'complicated' named entity 'scrub typhus' named entity 'acute respiratory distress syndrome' named entity 'assay' named entity 'vasculitis' named entity 'scrub typhus' named entity 'scrub typhus' named entity 'Mycoplasma pneumoniae' named entity 'outpatient' named entity 'Asia' named entity 'doxycycline' named entity 'X-ray' named entity 'assay' named entity 'Body temperature' named entity 'eschar' named entity 'albumin' named entity 'ulcers' named entity 'IgM' named entity 'ulcer' named entity 'Mycoplasma pneumoniae' named entity 'pleural effusion' named entity 'scrub typhus' named entity 'antibiotics' named entity 'Hemophagocytic syndrome' named entity 'doxycycline' named entity 'scrub typhus' named entity 'chest CT' named entity 'inflammatory factors' named entity 'ceftriaxone' named entity 'India' named entity 'hepatosplenomegaly' named entity 'thigh' named entity 'hyperthermia' named entity 'scrub typhus' named entity 'pediatricians' named entity 'hepatitis' named entity 'penicillin' named entity 'chloramphenicol' named entity 'erythema' named entity 'virus' named entity 'IL-1β' named entity 'itching' named entity 'scrub typhus' named entity 'bone marrow smears' named entity 'chloramphenicol' named entity 'doxycycline' named entity 'assay' named entity 'cefoperazone' named entity 'eschar' named entity 'Scrub typhus' named entity 'Taiwan' named entity 'misdiagnosis' named entity 'eschar' named entity 'hemophagocytosis' named entity 'misdiagnosis' named entity 'scrub typhus' named entity 'penicillin' named entity 'bone marrow' named entity 'scrub typhus' named entity 'sulbactam' named entity '1:160' named entity 'ARDS' named entity 'eschar' named entity 'immunofluorescent' named entity 'epidemiology' named entity 'blood lipids' named entity 'assay' named entity 'Taiwan' named entity 'misdiagnosis' named entity 'vascular endothelial cells' named entity 'fever' named entity 'immunofluorescent' named entity 'scrub typhus' named entity 'ceftazidime' named entity 'bone marrow examination'

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