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 Original Articles |
| A Clinical Study of 120 Cases with Tsutsugamushi Disease |
| Bum Moon, Kang Woo Paek, Gi Tae Kim, Chang Whan Park, Do Hyun Rhew, Sung Kyu Choi, Jong Sun Rew, Chong Mann Yoon |
| Department of Internal Medicine Chonnam University Medical School, Kwangju, Korea |
Vol.27 Num.3 (p273~279)
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Background : As tsutsugamushi disease is one of the endemic febrile illness during fall season in Korea, it is necessary to distinguish clinically tsutsugamushi disease from leptospirosis or hemorrhagic fever with renal syndrome for early adequate treatment.
Methods : One hundred and twenty cases of tsutsugamushi disease were analyzed clinically and epidemiologically, which were diagnosed at Chonnam University hospital, Kwangju Hankook hospital, Mokpo hospital, Sooncheon hospital and Yeonggwang hospital in Chonnam province from 1990 to 1993.
Results :
1) For one hundred and twenty cases, the age distribution ranged from the twenties to eighties and the disease was most common in the 6th decade(32.5%), 7th decade(21.6%) and 8th decade(21.6%). Male to female ratio was 1:1.3. The monthly distribution rate was highest in November(53.4%), followed by 40.8% in October, 3.3% in December, and 2.5% in September.
2) The percentages of frequency of major symptoms were as follows : fever and chills, 83.9%; headache, 55.8%; myalgia, 55.0%. Eschar, rash and conjunctival injection were present in 75.0%, 52.5% and 15.8%, respectively.
3) Abnormal liver function test, chest X-ray, and EKG were present in 75.0%, 17.5% and 23.3% respectively. The serologic diagnosis was made by indirect immunofluorescent antibody test in 70% of cases; serologic cross reactions with Hantavirus or Leptospira in 3.4% and 1.7% of cases, respectively.
4) All of the patients were satisfactorily cured with doxycycline. However, the uncommon complications were myocarditis in one case and Guillain-Barr? syndrome in two cases, which were recovered without sequelae.
Conclusion : Tsutsugamushi disease is an acute febrile illness which is characterized by fever, chills, headache, myalgia, rash and eschar during autumn. Therefore, we have to make every effort to make early clinical diagnosis and to start empirical treatment before the serologic diagnosis.
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Keywords : Tsutsugamushi disease, Clinical diagnosis |
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