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CASE REPORT
Detection of Rickettsia japonica-DNA from Blood Crust Forming After the Eschar Biopsy in a Case of Japanese Spotted Fever
1)Department of Internal Medicine, Okayama Saiseikai General Hospital, 2)Department of Gastroenteroly, Okayama University Hospital, 3)Okayama Prefectural Institute for Environmental Science and Public Health, 4)Mahara Institute of Medical Acarology
Shunsuke DAIDO1), Manri KAWAKAMI1), Mari TAKASHIMA1), Ryoichi HARADA1), Shinichi FUJIOKA1), Fusao IKEDA2), Koji KIDA3), Yasuhiro MATSUOKA3), Toshio KISHIMOTO3) & Hiromi FUJITA4)
(Received May 21, 2018)
(Accepted October 24, 2018)
Key words: Japanese spotted fever, blood crust, polymerase chain reaction (PCR)
Abstract

We report herein on the case of a 54-year-old Japanese male diagnosed as having Rickettsia disease based on the detection of Rickettsia japonica in the blood crust from the biopsy scar of an eschar. In late September 2016, the patient suffered from a 39°C fever and visited a hospital. He had an eschar on the right abdomen and a rash present over the whole body. Blood tests showed thrombocytopenia, severe inflammation, and mild liver dysfunction. A real-time PCR procedure detected Rickettsia japonica DNA in the blood crust from the biopsy scar of the eschar, suggesting Japanese spotted fever. He recovered well from the disease with the administration of minocycline and ciprofloxacin. The PCR detection of R. japonica DNA in the blood crust from a biopsy scar of an eschar can be a sensitive method for the early diagnosis of Rickettsia disease.

[ Kansenshogaku Zasshi 93: 21-24, 2019 ]

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