Abstract
Scrub typhus is an acute febrile illness caused by the intracellular pathogen Orientia tsutsugamushi. The clinical features include fever, myalgia, lymphadenopathy, and dry mouth. However, no studies have assessed the symptom of dry mouth in patients with scrub typhus. We investigated the pattern of salivary scintigraphy during the acute febrile state and compared it with any changes after treatment. Fourteen patients underwent both pre- and post-treatment salivary scintigraphy. Imaging analysis was conducted using radioactivity in the oral cavity, parotid glands, and submandibular glands. During the acute phase, the radioactivity in the oral cavity markedly decreased, while that in the parotid and submandibular glands was preserved. After treatment, radioactivity in the oral cavity showed a significant increase at 20-min, 40-min, and after wash-out. The ejection fraction (%) of the parotid glands also increased after treatment. In contrast, the radioactivity levels of the parotid and submandibular glands were not statistically different after treatment. Salivary scintigraphy indicated that insufficient saliva excretion from the salivary glands into the oral cavity was one reason for the dry mouth reported by patients with scrub typhus. In the future, salivary scintigraphy imaging could contribute to the evaluation of dry mouth in patients with scrub typhus.
Highlights
Scrub typhus is an acute febrile illness caused by the intracellular pathogen Orientia tsutsugamushi, which is transmitted to human by an infected chigger bite[1]
Dry mouth is one of the most common clinical features reported by patients with scrub typhus
We demonstrated using salivary scintigraphy that dry mouth is caused by decreased excretory capacity from the salivary glands in the oral cavity
Summary
Scrub typhus is an acute febrile illness caused by the intracellular pathogen Orientia tsutsugamushi. Salivary scintigraphy indicated that insufficient saliva excretion from the salivary glands into the oral cavity was one reason for the dry mouth reported by patients with scrub typhus. Salivary scintigraphy imaging could contribute to the evaluation of dry mouth in patients with scrub typhus. Scrub typhus is an acute febrile illness caused by the intracellular pathogen Orientia tsutsugamushi, which is transmitted to human by an infected chigger bite[1]. Salivary scintigraphy helps us to evaluate the function of major salivary glands and the patency of salivary ducts and allows the diagnosis of acute/chronic salivary gland disorders and tumors[9] It has been performed mostly in patients with radiation-induced xerostomia and autoimmune diseases such as Sjögren syndrome.
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