Scrub typhus hepatitis confirmed by immunohistochemical staining

作     者：Jong-Hoon Chung Sung-Chul Lim Na-Ra Yun Sung-Heui Shin Choon-Mee Kim Dong-Min Kim 

作者机构：Department of Internal MedicineChosun University College of MedicineGwangju 501-717South Korea Research Center for Resistant CellsChosun UniversityGwangju 501-717South Korea Department of PathologyChosun University College of MedicineGwangju 501-717South Korea Department of MicrobiologyChosun University College of MedicineGwangju 501-717South Korea 

出 版 物：《世界胃肠病学杂志：英文版》 (World Journal of Gastroenterology)

年 卷 期：2012年第18卷第36期

页      面：5138-5141页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by The Korea Science and Engineering Foundation Grant Funded by the Korean Government through the Research Center for Resistant Cells  No. R13-2003-009 

主　　题：病毒性肝炎 免疫组化染色 恙虫病 巢式聚合酶链反应 组织病理学检查 血清学试验 肝功能损害 免疫反应 

摘      要：Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi(O.tsutsugamushi).We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by histopathological examination of liver biopsy specimens,serological tests and nested polymerase chain reaction.Immunohistochemical staining using a monoclonal anti-O.tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes.This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis.Thus,scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses,which causes severe lobular disarray with diffuse hepatocytic degeneration,necrosis and apoptosis as well as findings indicative of hepatic cholestasis,such as hepatic bile plugs or brown pigmentation of hepatocytes.