Japanese Spotted Fever with Severe Myositis: A Diagnostic Challenge.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Internal Medicine Pub Date : 2024-12-26 DOI:10.2169/internalmedicine.4813-24

Keigo Kobayashi, Haruna Baba, Riki Takeda, Susumu Nishiyama, Shu Nakamoto, Yasuhiro Umekawa

引用次数: 0

Abstract

A woman in her late 70s presented with a fever, rashes, and marked proximal muscle weakness. Noninfectious conditions, including myositis and vasculitis, were initially considered. Treatment with cephalosporins was ineffective, but the symptoms improved with minocycline, indicating possible Japanese spotted fever (JSF) despite no apparent history of tick exposure. The diagnosis was confirmed by serological tests. A skin biopsy revealed leukocytoclastic vasculitis with immune complex deposition, suggesting muscle damage due to immune complexes. This case underscores the need to consider JSF in patients with atypical symptoms and initiate timely treatment to prevent severe complications.

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日本斑疹热伴严重肌炎：诊断挑战。

一位70多岁的女性表现为发烧，皮疹和明显的近端肌肉无力。非传染性疾病，包括肌炎和血管炎，最初被考虑。头孢菌素治疗无效，但米诺环素改善了症状，提示可能是日本斑疹热（JSF），尽管没有明显的蜱虫接触史。血清学检查证实了诊断。皮肤活检显示白细胞破裂性血管炎伴免疫复合物沉积，提示免疫复合物引起的肌肉损伤。该病例强调了在非典型症状患者中考虑JSF的必要性，并及时开始治疗以防止严重并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.