A Case of Critical Japanese Spotted Fever in Zhejiang, China

Abstract

Background

Japanese spotted fever (JSF) is a rare disease, caused by Rickettsia japonica; no case has been reported in Zhejiang Province, China.

Case Presentation

An elderly woman presented to the hospital with abdominal pain and fever. Her condition rapidly worsened with severe complications, such as multiple organ failure and central nervous system damage. The presence of R. japonica was quickly detected by metagenomic next-generation sequencing. On the basis of combined clinical manifestations and laboratory results, critical JSF was diagnosed and treated with doxycycline. The patient showed good prognosis. Typical symptoms (eschar and rash) were not observed in the early stage, consequently increasing the difficulty of clinical diagnosis.

Conclusion

The delay of treatment caused by non-specific symptoms is an important factor affecting the progression of JSF. As an emerging pathogen detection method, mNGS has been successfully applied for disease diagnosis and treatment, and can be an important complement for the diagnosis of this disease.

Keywords:

• Japanese spotted fever
• Rickettsia japonica
• spotted fever group Rickettsia
• mNGS
• fever
• multiple organ failure
• central nervous system damage

Data Sharing Statement

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author.

Ethics Approval and Consent to Participate

Ethics approval or consent to participate was not applicable.

Consent for Publication

Written informed consent was provided by the patient for the publication of the case details and images. Details of the case can be published without institutional approval.

Acknowledgments

Many thanks for works by the staffs in the infectious ward from the Huzhou Central Hospital.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that no conflicts of interest exist.

Additional information

Funding

This work was supported by the Public welfare application research project of Zhejiang Science and Technology Department (No. LGF22H190006).