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-
1.
Agress CM, Evans ER, 1946. Clinical survey of 86 cases of scrub typhus. Bull US Army Med Dep 5: 163–169.
-
2.
Paris DH, Jenjaroen K, Blacksell SD, Phetsouvanh R, Wuthiekanun V, Newton PN, Day NP, Turner GD, 2008. Differential patterns of endothelial and leucocyte activation in ‘typhus-like’ illnesses in Laos and Thailand. Clin Exp Immunol 153: 63–67.
-
3.
Fang C, Dennis D, Lee J, 1977. Electrocardiographic changes in scrub typhus patients. Southeast Asian J Trop Med Public Health 8: 503–509.
-
4.
Lim JH, Kim ES, Chung MH, Kang JS, 2008. Torsades de pointes by azithromycin in scrub typhus and review on cardiac manifestations of scrub typhus. Infect Chemother 40: 58–62.
-
5.
Mookkappan S, Basheer A, Chidambaram S, Natarajan N, Shrimanth B, 2014. Transient adrenal insufficiency and post-treatment bradycardia in scrub typhus - a case report. Australas Med J 7: 164–167.
-
6.
Aronoff DM, Watt G, 2003. Prevalence of relative bradycardia in Orientia tsutsugamushi infection. Am J Trop Med Hyg 68: 477–479.
-
7.
Kumar R, Thakur S, Bhawani R, Kanga A, Ranjan A, 2016. Clinical profile and complications of scrub typhus: hospital-based study in sub-himalayan region. J Assoc Physicians India 64: 30–34.
-
8.
Deshmukh MD, 1945. Clinical picture of scrub typhus in East African troops on the Burma front. East Afr Med J 22: 360–367.
-
9.
Agress CMEC, 1946. Clinical survey of 86 cases of scrub typhus. Bull US Army Med Dep 5: 163–169.
-
10.
Fang R, Lin W, Chao P, Kuo N, Chen C, 1975. Clinical observations of scrub typhus on Penghu (the Pescadores Islands). Trop Geogr Med 27: 143–150.
-
11.
Kim DM, Yun NR, Yang TY, Lee JH, Yang JT, Shim SK, Choi EN, Park MY, Lee SH, 2006. Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study. Am J Trop Med Hyg 75: 542–545.
-
12.
Kim YS, Yun HJ, Shim SK, Koo SH, Kim SY, Kim S, 2004. A comparative trial of a single dose of azithromycin versus doxycycline for the treatment of mild scrub typhus. Clin Infect Dis 39: 1329–1335.
-
13.
Johnson DH, Cunha BA, 1993. Atypical pneumonias: clinical and extrapulmonary features of Chlamydia, mycoplasma, and legionella infections. Postgrad Med 93: 69–82.
-
14.
Cunha BA, 2000. The diagnostic significance of relative bradycardia in infectious disease. Clin Microbiol Infect 6: 633–634.
-
15.
Kim N, Rosenbaum GS, Cunha BA, 1998. Relative bradycardia and lymphopenia in patients with babesiosis. Clin Infect Dis 26: 1218–1219.
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Relative Bradycardia in Scrub Typhus
Lae Young Jung
Lae Young Jung
Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea;
Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Mir Jeon
Mir Jeon
Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea;
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Seung Hee Choi
Seung Hee Choi
Industrial Design, Chonbuk National University, Jeonju, Republic of Korea
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Joo-Hee Hwang
Joo-Hee Hwang
Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea;
Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Chang-Seop Lee
Chang-Seop Lee
Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea;
Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Kyoung-Suk Rhee
Kyoung-Suk Rhee
Department of Internal Medicine, Chonbuk National University, Jeonju, Republic of Korea;
Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea;
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To investigate the relationship between heart rate and temperature, we examined 493 febrile patients with documented disease. These patients were diagnosed serologically and analyzed retrospectively: 337 (68.4%) responded to fever with increased heart rate < 10 beats/minute/°C (relative bradycardia [RB]), and 156 patients had a heart rate response ≥ 10 beats/minute/°C (general heart rate increase [GHRI]). The RB group had a higher median resting heart rate and lower heart rate at maximum temperature than the GHRI group. Despite differences in heart rate response, no significant differences were seen in clinical outcomes (acute kidney injury, systemic inflammatory response syndrome (SIRS), and death). We concluded that most patients with scrub typhus presented with RB. In scrub typhus infection, RB can be included as one of the clinical features for differential diagnosis from other infectious diseases.
Author Notes
Authors’ addresses: Lae Young Jung, Mir Jeon, Seung Hee Choi, Joo-Hee Hwang, Chang-Seop Lee, and Kyoung-Suk Rhee, Chonbuk National University, Internal Medicine, Jeonju, Jeollabuk-do, Republic of Korea, E-mails: youngjoin@naver.com, preciousmir@gmail.com, designsopung@naver.com, zany78@naver.com, lcsmd@jbnu.ac.kr, and ksee@jbnu.ac.kr.
Financial support: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C0950). This article was supported by research funds from Chonbuk National University in 2017 and by a fund from the Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Agress CM, Evans ER, 1946. Clinical survey of 86 cases of scrub typhus. Bull US Army Med Dep 5: 163–169.
-
2.
Paris DH, Jenjaroen K, Blacksell SD, Phetsouvanh R, Wuthiekanun V, Newton PN, Day NP, Turner GD, 2008. Differential patterns of endothelial and leucocyte activation in ‘typhus-like’ illnesses in Laos and Thailand. Clin Exp Immunol 153: 63–67.
-
3.
Fang C, Dennis D, Lee J, 1977. Electrocardiographic changes in scrub typhus patients. Southeast Asian J Trop Med Public Health 8: 503–509.
-
4.
Lim JH, Kim ES, Chung MH, Kang JS, 2008. Torsades de pointes by azithromycin in scrub typhus and review on cardiac manifestations of scrub typhus. Infect Chemother 40: 58–62.
-
5.
Mookkappan S, Basheer A, Chidambaram S, Natarajan N, Shrimanth B, 2014. Transient adrenal insufficiency and post-treatment bradycardia in scrub typhus - a case report. Australas Med J 7: 164–167.
-
6.
Aronoff DM, Watt G, 2003. Prevalence of relative bradycardia in Orientia tsutsugamushi infection. Am J Trop Med Hyg 68: 477–479.
-
7.
Kumar R, Thakur S, Bhawani R, Kanga A, Ranjan A, 2016. Clinical profile and complications of scrub typhus: hospital-based study in sub-himalayan region. J Assoc Physicians India 64: 30–34.
-
8.
Deshmukh MD, 1945. Clinical picture of scrub typhus in East African troops on the Burma front. East Afr Med J 22: 360–367.
-
9.
Agress CMEC, 1946. Clinical survey of 86 cases of scrub typhus. Bull US Army Med Dep 5: 163–169.
-
10.
Fang R, Lin W, Chao P, Kuo N, Chen C, 1975. Clinical observations of scrub typhus on Penghu (the Pescadores Islands). Trop Geogr Med 27: 143–150.
-
11.
Kim DM, Yun NR, Yang TY, Lee JH, Yang JT, Shim SK, Choi EN, Park MY, Lee SH, 2006. Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study. Am J Trop Med Hyg 75: 542–545.
-
12.
Kim YS, Yun HJ, Shim SK, Koo SH, Kim SY, Kim S, 2004. A comparative trial of a single dose of azithromycin versus doxycycline for the treatment of mild scrub typhus. Clin Infect Dis 39: 1329–1335.
-
13.
Johnson DH, Cunha BA, 1993. Atypical pneumonias: clinical and extrapulmonary features of Chlamydia, mycoplasma, and legionella infections. Postgrad Med 93: 69–82.
-
14.
Cunha BA, 2000. The diagnostic significance of relative bradycardia in infectious disease. Clin Microbiol Infect 6: 633–634.
-
15.
Kim N, Rosenbaum GS, Cunha BA, 1998. Relative bradycardia and lymphopenia in patients with babesiosis. Clin Infect Dis 26: 1218–1219.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 318 | 262 | 42 |
| Full Text Views | 448 | 14 | 0 |
| PDF Downloads | 186 | 7 | 0 |