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The Third Case of Japanese Spotted Fever on Tokunoshima Island in Kagoshima Prefecture Cured with Tetracycline Alone and Epidemiological Investigation
1)Division of Internal Medicine, Nanmei-kai Miyagami Hospital, 2)Kagoshima Prefectural Institute of Environmental Research and Public Health, 3)Mahara Institute of Medical Acarology, 4)Department of Pharmacy, Nanmei-kai Miyagami Hospital, 5)Department of Infection Control and Prevention, Faculty of Medical Science, University of Fukui
Akira KOBAYASHI1), Mutsuyo GOKUTEN2), Hiromi FUJITA3), Maki SUZUKI4) & Hiromichi IWASAKI5)
(Received December 19, 2017)
(Accepted April 19, 2018)
Key words: Japanese spotted fever, minocycline, Tokunoshim Island

A 49-year-old man was admitted to a local hospital on Tokunoshima Island in Kagoshima prefecture, Japan, after he experienced high fever and general fatigue for several days. A physical examination on admission revealed his temperature to be over 39.5°C, an eschar on the left thigh, and generalized skin erythema. Laboratory examination revealed thrombocytopenia, liver dysfunction, and raised levels of C-reactive protein. He was suspected to have Spotted Fever and recovered with the help of immediate treatment with minocycline alone. He was finally diagnosed as having Japanese Spotted Fever, which was confirmed based on antibodies positive for Rickettsia japonica detected with an immunofluorescence test using paired sera and DNA determination specific to R. japonica extracted from the eschar using PCR. Since Japanese Spotted Fever can be life-threatening if diagnosis and appropriate treatment are delayed, it should always be considered as a differential diagnosis for patients presenting with high fever and eruptions.

[ Kansenshogaku Zasshi 92: 547-551, 2018 ]

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