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 Original Articles |
| Reevaluation of the Importance of Finding Rash, Lymphadenitis and Eschars for the Early Clinical Diagnosis of Tsutsugamushi Disease |
| Kang Su Yi1, Sung Kun Yoo2, Wan Ko3, Won Young Lee4, Chin Ki Pai5, Ki Il Kim6, Yunsop Chong |
| Yi's Clinic of Internal Medicine1, Hyundai Clinic2, Ko's Clinic of Internal Medicine3, Seran Clinic of Obstetrics and Gynecology4, Minjoong Clinic5 and Koryo Clinic6, Chinhae, Korea, Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea |
Vol.23 Num.3 (p163~169)
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Early diagnosis of tsutsugamushi disease (scrub typhus) is important for antimicrobial treatment of the patient. Previously, we repored that early diagnosis was possible based on the observation of rash, lymphadenitis or eschars in most of the suspected patients. However, the low frequency of these findings in some reports may indicate we may miss some tsutsugamushi disease patients. In this study the accuracy of the clinical diagnosis based on these findings were reevaluated. Two groups of febrile patients, seen at clinics in Chinhae in 1990, were tested for IFA antibdy against R. tsutsugamushi. Among the 32 patients with rash, lymphadenitis or eschars, 94% showed serological evidence of tsutsugamushi disease, while none of the 31 febrile patients without these findings. It is concluded that most of the clinical diagnosis of tsutsugamushi disease of the patients with these findings are accurate and that febrile patients without these findings in the early stage of the disease are rarely tsutsugamushi disease.
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