{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T20:00:14Z","timestamp":1762113614274},"reference-count":32,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,12,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>Spontaneous rupture of the spleen is rarely described as a complication of scrub typhus infection. We report a previously healthy 74-year-old Thai female farmer who presented in Nakhon Ratchasima, Thailand, with a history of fever and malaise for 5 days, followed by abdominal pain for 1 day. An exploratory laparotomy was performed due to peritonitis. Operative findings revealed a ruptured spleen and hemoperitoneum. A splenectomy was performed afterward. Scrub typhus was confirmed by a 4-fold increase of IgM titer using an indirect immunofluorescence antibody assay and a positive result from the polymerase chain reaction targeting the 47- and 56-kDa genes in <jats:italic>Orientia tsutsugamushi<\/jats:italic>. She responded well to intravenous chloramphenicol and defervesced within 24 hours without any complication.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0089","type":"journal-article","created":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T03:29:34Z","timestamp":1475551774000},"page":"1284-1286","source":"Crossref","is-referenced-by-count":5,"title":["Spontaneous Splenic Rupture Caused by Scrub Typhus"],"prefix":"10.4269","volume":"95","author":[{"given":"Wilawan","family":"Thipmontree","sequence":"first","affiliation":[{"name":"Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kittipong","family":"Suwattanabunpot","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yupin","family":"Supputtamonkol","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Curr Opin Infect Dis","first-page":"429","article-title":"Scrub typhus and tropical rickettsioses","volume":"16","author":"Watt","year":"2003"},{"key":"ref2","series-title":"Am J Trop Med Hyg","first-page":"368","article-title":"Diagnosis of scrub typhus","volume":"82","author":"Koh","year":"2010"},{"key":"ref3","series-title":"Southeast Asian J Trop Med Public Health","first-page":"780","article-title":"Septic shock secondary to scrub typhus: characteristics and complications","volume":"33","author":"Thap","year":"2002"},{"key":"ref4","series-title":"Int J Gerontol","first-page":"223","article-title":"Radiologic 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case of acute renal failure, rhabdomyolysis and disseminated intravascular coagulation associated with scrub typhus","volume":"60","author":"Lee","year":"2003"},{"issue":"(Suppl 3)","key":"ref10","series-title":"Clin Infect Dis","first-page":"S203","article-title":"Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi","volume":"48","author":"Kelly","year":"2009"},{"key":"ref11","series-title":"Asian Pac J Trop Med","first-page":"261","article-title":"Scrub typhus: pathophysiology, clinical manifestations and prognosis","volume":"5","author":"Rajapakse","year":"2012"},{"key":"ref12","series-title":"J Clin Microbiol","first-page":"430","article-title":"Association of high Orientia tsutsugamushi DNA loads with disease of greater severity in adults with scrub typhus","volume":"47","author":"Sonthayanon","year":"2009"},{"key":"ref13","series-title":"Arch Gerontol Geriatr","first-page":"196","article-title":"Differences in the clinical 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analysis of 55 cases (1958\u20132008)","volume":"7","author":"Imbert","year":"2009"},{"key":"ref28","series-title":"Cochrane Database Syst Rev","first-page":"CD002150","article-title":"Antibiotics for treating scrub typhus","author":"Panpanich","year":"2000"},{"key":"ref29","series-title":"Trop Doct","first-page":"1","article-title":"Drug treatment of scrub typhus","volume":"41","author":"Rajapakse","year":"2011"},{"key":"ref30","series-title":"Intern Med","first-page":"2313","article-title":"Meta-analysis of drug treatment for scrub typhus in Asia","volume":"51","author":"Fang","year":"2012"},{"key":"ref31","series-title":"Arch Intern Med","first-page":"77","article-title":"Scrub typhus. 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