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A Clinical Study of Tsutsugamushi Disease Occurred in Seoul and Kyungki Do in Autumn of 1987
Young Ki Kim, June Myeung Kim, Eung Kim, Dong Kyoon Chung, Young Hwan Ham, Chein Soo Hong, Yunsop Chong*
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea, Department of Clinical Pathology*
Vol.20 Num.2 (p93~103)
Tsutsugamushi disease is an acute febrile disease which is characterized by fever, headache, rashes and eschar. In Korea it has beenreported with increasing frequencies through the nation since 1986.
We have conducted a survey on 18 clinically suspected and serologically confirmed case of tsutsugamushi disease in Seoul and Kyungki Do from October 1987 to November 1987 and came up with following results.
Of 18 cases, 11 were females and 7 were males. The mean age of the patients was 52 years ranging from 27 to 82 years. Twelve patients were found to be residing in the urban areas and 11 of these patients had a history of recent travel before the onset of the disease., suggesting acquisition of the disease from traveling in rural areas, and we were able to predict nation wide distribution of the disease. The most frequent symptoms were headache (100%), fever(100%) and chills (100%). Eschar was observed in 17 of 18 patients studies (94%). Common laboratory featureas include leukocytosis in 6 cases (33%), SGOT elevation in 17 cases (94%), SGPT elevation in 16 cases (89%). LDH elevation in 15 of 15 studied cases (100%) and the elevation in CK level in 1 of 6 studied cases(22%). On chest X-ray films, interstitial pneumonia was observed in 9 cases (31%), FDP was positive in 4 of 15 studied cases (25%), antithrombin-III was decreased in 5 of 7 patients (71%) and prolonged PT, PTT were observed in 2 of 18 patients (11%), each. Clinical improvement was noticed in all but one patient with either tetracycline or chloramphenicol treatment. The mean duration from the start of the treatment to the defervescence of fever was 1.8 days with tetracycline therapy and 2.1 days with cholramphenicol. During their clinical course, DIC was observed in 2 patient who did not have other superimposed infectrion. The mortality had occured in 1 patient complicated with pneumonia and ARDS.
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