Abstract：
Japanese spotted fever is an emerging rickettsiosis caused by Rickettsia japonica and is characterized by high fever, rash, and eschar formation. Other symptoms are often vague and nonspecific and include headaches, nausea, vomiting, and myalgia. We present a case of a 46-year-old woman with Japanese spotted fever, complicated by transient bilateral sensorineural hearing loss and presenting cutaneous IgM/IgG immune complex vasculitis. The patient was admitted with a history of several days of high fever, generalized skin erythema, and hearing impairment. Laboratory findings revealed thrombocytopenia and elevated liver enzyme and C-reactive protein levels. Pure-tone audiometry revealed bilateral sensorineural hearing loss, and a skin biopsy revealed leukocytoclastic vasculitis with deposition of C3 and IgM on the vessel walls. Under the tentative diagnosis of rickettsiosis, scrub typhus, or Japanese spotted fever, the patient was treated with minocycline, and her symptoms improved within approximately 10 days. A definitive diagnosis was made on the basis of a serological test showing increased antibody levels against Rickettsia japonica. Japanese spotted fever can cause transient sensorineural hearing loss, a rare complication that presents with cutaneous IgM/IgG immune complex vasculitis.
摘要：
日本斑疹热是由日本立克次体引起的一种新兴立克次体病，以高热为特征，皮疹,和焦痂形成。其他症状通常是模糊和非特异性的，包括头痛，恶心,呕吐,和肌痛。我们介绍了一例46岁的日本斑疹热女性,并发短暂性双侧感音神经性耳聋，并表现为皮肤IgM/IgG免疫复合物血管炎。病人入院时有数日高烧史,全身性皮肤红斑,和听力障碍。实验室发现血小板减少，肝酶和C反应蛋白水平升高。纯音测听显示双侧感觉神经性听力损失，皮肤活检显示白细胞碎裂性血管炎，血管壁上有C3和IgM沉积。在立克次体病的初步诊断下，斑疹伤寒,或者日本斑点热，患者接受米诺环素治疗,她的症状在大约10天内有所改善。根据血清学测试表明抗日本立克次体的抗体水平升高，做出了明确的诊断。日本斑点热会导致短暂的感觉神经性听力损失，一种罕见的并发症，表现为皮肤IgM/IgG免疫复合物血管炎。
