Scrub typhus history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History and Symptoms
Symptoms include fever, headache, muscle pain, cough, and gastrointestinal symptoms. More virulent strains of O. tsutsugamushi can cause hemorrhaging and intravascular coagulation. Maculopapular rash, eschar, splenomegaly and lymphadenopathies are typical signs. Leukopenia and abnormal liver function tests are commonly seen in the early phase of the illness. Pneumonitis, encephalitis, and myocarditis occur in the late phase of illness.
Acute scrub typhus appears to improve viral loads in patients with HIV.[1] This interaction is refused by an in vitro study.[2]
Symptoms consist of skin flushing, throbbing headache, oral burning, abdominal cramps, nausea, diarrhea, palpitations, a sense of unease, and, rarely, collapse or loss of vision. Symptoms usually occur within 10–30 minutes of ingesting the fish and generally are self-limited. Physical signs may include a diffuse blanching erythema, tachycardia, wheezing, and hypotension or hypertension. People with asthma are more vulnerable to respiratory problems such as wheezing or bronchospasms. Symptoms of poisoning can show within just minutes, and up to two hours, following consumption of a spoiled dish. Symptoms usually last for approximately four to six hours and rarely exceed one to two days.
Initial
The first signs of poisoning suggest an allergic reaction with the following symptoms:
- facial flushing/sweating
- burning-peppery taste sensations in the mouth and throat
- dizziness
- nausea
- headache
- tachycardia
- cold like symptoms
Additional symptoms
The above symptoms can advance to the following:
- facial rash
- torso or body rash. The rash associated with scombroid poisoning is a form of urticaria, but most commonly does not include wheals (patchy areas of skin-swelling also known as hives) that may be seen in true allergies.[3]
- edema (this is generalized if it occurs at all)
- short-term diarrhea
- abdominal cramps.
Severe
In the worst cases, the poisoning may cause:
- blurred vision
- respiratory stress
- swelling of the tongue
References
- ↑ Watt G; Kantipong P; de Souza M; et al. (2000). "HIV-1 suppression during acute scrub-typhus infection". Lancet. 356 (9228): 475–479. doi:10.1016/S0140-6736(00)02557-5. PMID 10981892. Unknown parameter
|author-separator=ignored (help) - ↑ Moriuchi M, Tamura A, Moriuchi H. (2003). "In vitro reactivation of human immunodeficiency virus-1 upon stimulation with scrub typhus rickettsial infection". Am J Trop Med Hyg. 68 (5): 557–561. PMID 12812345.
- ↑ http://dermnetnz.org/reactions/scombroid.html