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Fatal Rickettsia Japonica Infection Complicating Disseminated Intravascular Coagulation in Yichang, China

Siyu Gao1, Lingfeng Li2, Xiaolin Zhou1

  • 1Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, People's Republic of China.

Infection and Drug Resistance
|November 17, 2022
PubMed
Abstract

Insights

Rickettsia japonica infection can cause severe complications, including fatal outcomes. Disseminated intravascular coagulation in critical cases significantly increases the risk of poor prognosis.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genomics

Background:

  • Severe complications of Rickettsia japonica infection are poorly understood.
  • Rickettsia japonica is an emerging infectious agent.
  • Early diagnosis and understanding of Rickettsia japonica are crucial.

Observation:

  • Metagenomics next-generation sequencing (mNGS) identified 11 patients with Rickettsia japonica infection.
  • Common symptoms include fever, rash, abnormal urine, and cytopenias (neutropenia, lymphopenia, thrombocytopenia).
  • Severe cases presented with neurological manifestations, vomiting, and disseminated intravascular coagulation (DIC).

Findings:

  • Critical Rickettsia japonica infection with DIC is associated with a high risk of poor outcomes.
  • Severe cases showed higher rates of systemic and neurological manifestations.
  • Complications included purpura fulminans and mortality (16.6%).

Implications:

  • Disseminated intravascular coagulation is a key predictor of severe outcomes in Rickettsia japonica infection.
  • This study highlights the need for vigilant monitoring and management of Rickettsia japonica patients, especially those with DIC.
  • Further research into Rickettsia japonica pathogenesis and treatment is warranted.
Keywords:
Japanese spotted feverRickettsia japonicadisseminated intravascular coagulationinfectionpurpura fulminanstick

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