Kaohsiung Journal of Medical Sciences
Volume 24, Issue 2 , Pages 92-98, February 2008

Immunohistochemical Study of Scrub Typhus: A Report of Two Cases

  • Bo-Yuan Tseng

      Affiliations

    • Department of Pathology, Buddhist Tzu Chi General Hospital and University, Hualien, Taiwan
    • ,
  • Hui-Hua Yang

      Affiliations

    • Department of Virology, Buddhist Tzu Chi General Hospital and University, Hualien, Taiwan
    • ,
  • Ji-Hung Liou

      Affiliations

    • Department of Pathology, Buddhist Tzu Chi General Hospital and University, Hualien, Taiwan
    • ,
  • Li-Kuang Chen

      Affiliations

    • Department of Emergency Medicine, Buddhist Tzu Chi General Hospital and University, Hualien, Taiwan
    • ,
  • Yung-Hsiang Hsu

      Affiliations

    • Department of Pathology, Buddhist Tzu Chi General Hospital and University, Hualien, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Yung-Hsiang Hsu, Department of Pathology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, Hualien 940, Taiwan

Received 31 January 2007; accepted 10 July 2007.

Article Outline

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, which is transmitted by chiggers. The target cells of this rickettsia are poorly defined in humans. Immunohistochemical staining of tissue sections of patients with scrub typhus is helpful in investigating the target cells of this rickettsia in different organs. We studied two autopsy specimens by immunohistochemical staining using a specific antibody against O. tsutsugamushi. Rickettsiae were located in endothelial cells in all of the organs evaluated, namely heart, lung, brain, kidney, appendix and skin, within cardiac muscle cells and renal tubular epithelial cells, and in macrophages located in the lymph node, liver and spleen. In conclusion, O. tsutsugamushi may disseminate into multiple organs through endothelial cells and macrophages, resulting in the development of fatal complications.

Key Words:  immunohistochemistry , Orientia tsutsugamushi , scrub typhus

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References 

  1. Brown GW . Scrub typhus; pathogenesis and clinical syndrome . In:  Walker DH editors. Biology of Rickettsial Disease . Volume I: Boca Raton, FL: CRS Press; 1988;p. 93–100
  2. Wolbach SB , Todd JL , Palfrey FW . Pathology of Typhus in Man . In: The Etiology and Pathology of Typhus . Cambridge, MA: Harvard University Press; 1922;p. 152–221
  3. Laemmli UK . Cleavage of structural proteins during the assembly of the head of bacteriophage T4 . Nature . 1970;227:680–685
  4. Towbin H , Staehelin T , Gordon J . Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications . Proc Natl Acad Sci USA . 1979;6:4350–4354
  5. Shi SR , Key ME , Kalra KL . Antigen retrieval in formalinfixed, paraffin-embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections . J Histochem Cytochem . 1991;39:741–748
  6. Oaks EV , Rice RM , Kelly DJ , et al.   Antigenic and genetic relatedness of eight Rickettsia tsutsugamushi antigens . Infect Immun . 1989;57:3116–3122
  7. Ohashi M , Nashimoto H , Ikeda H , et al.   Diversity of immunodominant 56-kDa type-specific antigen (TSA) of Rickettsia tsutsugamushi. Sequence and comparative analyses of the genes encoding TSA homologues from four antigenic variants . J Biol Chem . 1992;267:12728–12735
  8. Oaks EV , Stover CK , Rice RM . Molecular cloning and expression of Rickettsia tsutsugamushi genes for two major protein antigens in Escherichia coli . Infect Immun . 1987;55:1156–1162
  9. Tamura A , Ohashi N , Urakami H , et al.   Analysis of polypeptide composition and antigenic components of Rickettsia tsutsugamushi by polyacrylamide gel electrophoresis and immunoblotting . Infect Immun . 1985;48:671–675
  10. Hanson B . Identification and partial characterization of Rickettsia tsutsugamushi major protein immunogens . Infect Immun . 1985;50:603–609
  11. Amano K , Tamura A , Ohashi N , et al.   Deficiency of peptidoglycan and lipopolysaccharide components in Rickettsia tsutsugamushi . Infect Immun . 1987;55:2290–2292
  12. Moron CG , Popov VL , Feng HM , et al.   Identification of the target cells of Orientia tsutsugamushi in human cases of scrub typhus . Mod Pathol . 2001;14:752–759
  13. Yang CH , Young TG , Peng MY , et al.   Unusual presentation of acute abdomen in scrub typhus: a report of two cases . Zhonghua Yi Xue Za Zhi (Taipei) . 1995;55:401–404
  14. Chen YC , Chao TY , Chin JC . Scrub typhus-associated hemophagocytic syndrome . Infection . 2000;28:178–179
  15. Takami A , Yamauchi H , Asakura H , et al.   Tsutsugamushi disease (scrub typhus)-associated hemophagocytic syndrome . Int J Hematol . 2002;75:337–338
  16. Jerrells TR , Osterman JV . Host defenses in experimental scrub typhus: delayed-type hypersensitivity responses of inbred mice . Infect Immun . 1982;35:117–123
  17. Nacy CA , Meltzer MS . Macrophages in resistance to rickettsial infection: macrophage activation in vitro for killing of Rickettsia tsutsugamushi . J Immunol . 1979;123:2544–2549
  18. Yotsukura M , Aoki N , Fukuzumi N , et al.   Review of a case of tsutsugamushi disease showing myocarditis and confirmation of Rickettsia by endomyocardial biopsy . Jpn Cir J . 1991;55:149–153
  19. Hsu GJ , Young T , Peng MY , et al.   Acute renal failure associated with scrub typhus: report of a case . J Formos Med Assoc . 1993;92:475–477
  20. Thomassen MJ , Kavuru MS . Human alveolar macrophages and monocytes as a source and target for nitric oxide . Int Immunopharmacol . 2001;1:1479–1490
  21. Kim PK , Zamora R , Petrosko P , et al.   The regulatory role of nitric oxide in apoptosis . Int Immunopharmacol . 2001;1:1421–1441
  22. Mitchell RN , Cotran RS . Acute and chronic inflammation . In:  Kumar V ,  Cotran RS ,  Robbins SL editor. Robbins Basic Pathology . 7th edition. Philadelphia: Saunders; 2003;p. 49–51

PII: S1607-551X(08)70103-7

doi:10.1016/S1607-551X(08)70103-7

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 2 , Pages 92-98, February 2008

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