Immunohistochemical Study of Scrub Typhus: A Report of Two Cases

以免疫組織化學染色法偵測恙蟲病病人組織內立克次體分佈之研究－兩病例報告

曾柏元(Bo-Yuan Tseng) ； 楊惠華(Hui-Hua Yang) ； 劉嘉鴻(Ji-Hung Liou) ； 陳立光(Li-Kuang Chen) ； 許永祥(Yung-Hsiang Hsu)

《The Kaohsiung Journal of Medical Sciences》 24卷2期 (2008/02) Pp. 92-98

摘要

恙蟲病病原是立克次體經由沙蚤媒介之人畜共通傳染病。此種立克次體在人類的標的細胞目前仍未釐清，免疫組識化學染色應用在恙蟲病病人組識切片上將可釐清這個立克次體的標的細胞，我們用47KD專一對抗立克次體的抗體將二例解剖標本作免疫組識化學染色，染色結果顯示立克次體分佈在所有標本包括心臟、肺臟、腎臟、蘭尾及皮膚的內皮細胞和腎臟腎小管上皮細胞、心肌細胞及淋巴腺、肝臟、脾臟內的吞噬細胞。恙蟲病立克次體可經由內皮細胞及吞噬細胞擴散到多個器官而造成致死性的併發症。

關鍵字

免疫組識化學染色 ； 日本秋恙蟲 ； 叢林型斑疹傷寒

並列摘要

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, which is transmitted by mchiggers. 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.

並列關鍵字

immunohistochemistry ； Orientia tsutsugamushi ； scrub typhus