Hoshino Chisho, Narita Masashi, Yamabe Akane, Sekikawa Yoshiyuki, Ishihara Kana, Ikeda Hiroshi, Satoh Noriyuki, Inoue Minoru
General Internal Medicine, Ohta-Nishinouchi Hospital, Japan.
Intern Med. 2011;50(21):2675-7. doi: 10.2169/internalmedicine.50.6048. Epub 2011 Nov 1.
A 67-year-old woman presented with melena and general weakness. Upper gastrointestinal (GI) endoscopy revealed multiple ulcers and projectile bleeding in the stomach. She also complained of a 10-day history of a fever and was diagnosed with scrub typhus based on a positive result of the eschar polymerase chain reaction (PCR) testing. She fully recovered with endoscopic hemostasis, and administration of minocycline and omeprazole. In a patient with GI manifestations, scrub typhus, a condition with pathologically systemic vasculitis, should be considered in the possible background in endemic areas. The eschar PCR testing is a rapid and useful diagnostic tool to identify a specific strain.
一名67岁女性因黑便和全身乏力就诊。上消化道内镜检查发现胃内有多处溃疡和喷射性出血。她还主诉发热10天,基于焦痂聚合酶链反应(PCR)检测结果呈阳性,被诊断为恙虫病。经内镜止血、给予米诺环素和奥美拉唑治疗后,她完全康复。对于有胃肠道表现的患者,在流行地区的可能背景下,应考虑恙虫病这种具有病理系统性血管炎的疾病。焦痂PCR检测是鉴定特定菌株的一种快速且有用的诊断工具。