Korean J Gastrointest Endosc.  2007 Jan;34(1):56-59.

A Case of Lower Gastrointestinal Bleeding with Ileal Ulceration in Scrub Typhus

• Baik SJ
• Shim KN
• Kang MJ
• Song HJ
• Ryu KH
• Yeom HJ
• Kim TH
• Jung SA
• Yoo K
• Moon IH
• Chung KW

Abstract

Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi-induced vasculitis, is common in Korea, Asia and Pacific Islands. Endoscopic mucosal lesions or mucosal damages have rarely been reported in Scrub typhus. However, four cases of upper gastrointestinal bleeding, controlled by hemoclipping, in Tsutsugamushi-infected patients have been reported in Korea; although, no case of lower gastrointestinal bleeding in Scrub typhus has been reported. We experienced massive hematochezia in a 77-year-old female patient with Scrub typhus. Special studies, including upper gastroduodenoscopy, colonoscopy, abdominal CT scan, and SMA angiography were performed, but the focus of the bleeding could not be found. An RBC scan showed suspicious small bowel bleeding, but a capsule endoscopy could not reveal the focus of the bleeding focus; however, a colonoscopy showed active bleeding at the terminal ileum, with multiple ileal ulcerations. After conservative therapy, the patient's condition was stable and the hematochezia disappeared.

Keyword

Scrub typhus; Hematochezia; leal ulceration

MeSH Terms

Aged
Angiography
Asia
Capsule Endoscopy
Colonoscopy
Female
Gastrointestinal Hemorrhage
Hemorrhage*
Humans
Ileum
Korea
Pacific Islands
Scrub Typhus*
Tomography, X-Ray Computed
Ulcer*
Vasculitis