Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity
Abstract Background Scrub typhus is an acute disease, characterized by symptoms of fever, which occurs due to infection by Orientia tsutsugamushi. In most cases, patients recover from the disease with appropriate treatment, but serious and fatal complications may occur. The present study examined la...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-019-3903-9 |
| _version_ | 1818879092838105088 |
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| author | Hyun Lee Kim Hye Rim Park Choon-Mee Kim Youn Jung Cha Na Ra Yun Dong-Min Kim |
| author_facet | Hyun Lee Kim Hye Rim Park Choon-Mee Kim Youn Jung Cha Na Ra Yun Dong-Min Kim |
| author_sort | Hyun Lee Kim |
| collection | DOAJ |
| description | Abstract Background Scrub typhus is an acute disease, characterized by symptoms of fever, which occurs due to infection by Orientia tsutsugamushi. In most cases, patients recover from the disease with appropriate treatment, but serious and fatal complications may occur. The present study examined laboratory findings and tumor necrosis factor-alpha (TNF-α) levels of scrub typhus patients to identify the prognostic predictors of disease severity. Method Patients whose scrub typhus diagnosis was confirmed by elevated indirect fluorescent antibody (IFA) levels and positive polymerase chain reaction (PCR) results were classified according to disease severity into one of three groups; i.e., deceased (n = 7), severe (n = 15), and mild (n = 15) retrospectively registered. Additionally, the usefulness of modified Acute Physiology and Chronic Health Evaluation II (APACHE II) score, C-reactive protein (CRP) level, white blood cell (WBC) count, and TNF-α level as prognostic predictors were examined. Result The mean TNF-α levels of the deceased, severe, and mild groups were 53.5 (range: 7.8–147.8), 26.0 (1.7–64.4), and 8.8 pg/mL (4.6–16.0), respectively. The results of Kruskal-Wallis tests showed statistically significant differences between the deceased and severe groups versus the mild group (p = 0.005). CRP level and Modified APACHE II score also differed significantly among the groups (p = 0.046 and 0.007, respectively); however, WBC count did not (p = 0.196). Conclusion An elevated serum TNF-α level in patients with scrub typhus could predict a severe condition or death and may be useful in predicting patient prognosis. |
| first_indexed | 2024-12-19T14:24:35Z |
| format | Article |
| id | doaj.art-3e3ea9989f734e48bbfe391564ea0f76 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-19T14:24:35Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-3e3ea9989f734e48bbfe391564ea0f762022-12-21T20:17:39ZengBMCBMC Infectious Diseases1471-23342019-03-011911510.1186/s12879-019-3903-9Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severityHyun Lee Kim0Hye Rim Park1Choon-Mee Kim2Youn Jung Cha3Na Ra Yun4Dong-Min Kim5Department of Internal Medicine, Chosun University College of MedicineDepartment of Internal Medicine, Chosun University College of MedicinePremedical sciences, College of Medicine, Chosun UniversityDepartment of Internal Medicine, Chosun University College of MedicineDepartment of Internal Medicine, Chosun University College of MedicineDepartment of Internal Medicine, Chosun University College of MedicineAbstract Background Scrub typhus is an acute disease, characterized by symptoms of fever, which occurs due to infection by Orientia tsutsugamushi. In most cases, patients recover from the disease with appropriate treatment, but serious and fatal complications may occur. The present study examined laboratory findings and tumor necrosis factor-alpha (TNF-α) levels of scrub typhus patients to identify the prognostic predictors of disease severity. Method Patients whose scrub typhus diagnosis was confirmed by elevated indirect fluorescent antibody (IFA) levels and positive polymerase chain reaction (PCR) results were classified according to disease severity into one of three groups; i.e., deceased (n = 7), severe (n = 15), and mild (n = 15) retrospectively registered. Additionally, the usefulness of modified Acute Physiology and Chronic Health Evaluation II (APACHE II) score, C-reactive protein (CRP) level, white blood cell (WBC) count, and TNF-α level as prognostic predictors were examined. Result The mean TNF-α levels of the deceased, severe, and mild groups were 53.5 (range: 7.8–147.8), 26.0 (1.7–64.4), and 8.8 pg/mL (4.6–16.0), respectively. The results of Kruskal-Wallis tests showed statistically significant differences between the deceased and severe groups versus the mild group (p = 0.005). CRP level and Modified APACHE II score also differed significantly among the groups (p = 0.046 and 0.007, respectively); however, WBC count did not (p = 0.196). Conclusion An elevated serum TNF-α level in patients with scrub typhus could predict a severe condition or death and may be useful in predicting patient prognosis.http://link.springer.com/article/10.1186/s12879-019-3903-9Scrub typhusPrognosisTNF-α levelAPACHE II |
| spellingShingle | Hyun Lee Kim Hye Rim Park Choon-Mee Kim Youn Jung Cha Na Ra Yun Dong-Min Kim Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity BMC Infectious Diseases Scrub typhus Prognosis TNF-α level APACHE II |
| title | Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity |
| title_full | Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity |
| title_fullStr | Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity |
| title_full_unstemmed | Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity |
| title_short | Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity |
| title_sort | indicators of severe prognosis of scrub typhus prognostic factors of scrub typhus severity |
| topic | Scrub typhus Prognosis TNF-α level APACHE II |
| url | http://link.springer.com/article/10.1186/s12879-019-3903-9 |
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