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Hepatic dysfunction in scrub typhus

C H Yang1, G J Hsu, M Y Peng

  • 1Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan R.O.C.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|March 1, 1995
PubMed
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Scrub typhus, an infectious disease, frequently causes liver dysfunction, affecting 77% of patients studied. This highlights the importance of considering scrub typhus in hepatitis-like cases, especially in endemic areas.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Tropical Medicine

Background:

  • Scrub typhus is an acute febrile illness common in the Asia-Pacific region, often presenting with non-specific symptoms.
  • Fever is the most common symptom, and it is a significant cause of fevers of unknown origin.
  • The association between scrub typhus and hepatic dysfunction is not well-documented in existing literature.

Purpose of the Study:

  • To investigate the prevalence and characteristics of hepatic dysfunction in patients diagnosed with scrub typhus.
  • To determine the frequency of liver function abnormalities in scrub typhus patients.
  • To assess the clinical significance of hepatocellular damage in scrub typhus.

Main Methods:

  • A retrospective study of 47 patients diagnosed with scrub typhus at Tri-Service General Hospital, Taipei, between 1982 and 1993.

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  • Review of medical records focusing on clinical presentation and liver function test results.
  • Analysis of liver function parameters including AST, ALT, alkaline phosphatase, LDH, and serum bilirubin.

    • Main Results:

    • Hepatic dysfunction was observed in 77% (36/47) of the studied scrub typhus patients.
    • Abnormalities in liver function tests were common, with elevated AST (74.5%) and ALT (74.5%) being most frequent.
    • Six patients exhibited symptoms resembling acute viral hepatitis, indicating significant hepatocellular damage.

    Conclusions:

    • Hepatocellular damage is a common manifestation of scrub typhus, occurring more frequently than previously recognized.
    • Clinicians should consider scrub typhus in the differential diagnosis of hepatitis-like illnesses, particularly in patients from endemic regions or high-risk groups.
    • Early diagnosis and treatment of scrub typhus can potentially prevent or mitigate liver damage.