Objective Based on the cases and literature,the clinical characteristics of septic shock caused by Rickettsia Japonica infection were analyzed to provide reference for the prevention of severe Japanese spotted fever(JSF).Methods By reporting a case of Rickettsia Japonica infection which rapidly progressed to septic shock,and combining with literature analysis,the clinical characteristics,diagnosis and treatment measures of JSF were summarized.Results The reported case presented with gastrointestinal symptoms as the initial manifestation,with a rapid progression to septic shock.The diagnosis was confirmed by metagenomics next-generation sequencing(mNGS),and the patient responded well to treatment with tetracycline antibiotics,leading to a full recovery and a favorable overall prognosis.A literature search identified 15 cases of Rickettsial infections caused by Rickettsia Japonica in domestic settings.All patients exhibited fever and rash,with a majority having more than seven days from onset to hospital admission.Laboratory tests revealed thrombocytopenia(12/15,80％),hypoproteinemia(8/15,53.3％)eosinopenia(7/15,46.7％)and coagulation dysfunction(6/15,40％)were the main cases.46.7％(7/15)patients progressed to severe disease and 1 case died.Conclusions Patients with JSF who experience prolonged time from onset to hospital admission and those with coagulation dysfunction may be at higher risk for severe JSF and poor prognosis.mNGS examination can improve the diagnostic efficiency of JSF.Suspected or confirmed cases of clinical symptoms should be treated as early as possible to help reduce complications and improve prognosis.
维普
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