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Original Articles
The Study of 46 Cases of Tsutsugamushi Disease in Young-Dong Region in Gang-Won-Do
Jin Gun Jang, M.D., Pae Gun Park, M.D., Hee Sob Lee, M.D., Joo Hee Maeng, M.D., Hyoun Sung Kim, M.D., Sung Chan Lee, M.D., Song Kyoo Yoon, M.D. and Jong Soo Choi, M.D.
Department of Internal Medicine, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea
Vol.35 Num.3 (p138~144)
Background:Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported.
Methods:We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001.
Results:Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications.
Conclusion:Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Keywords : Tsutsugamushi, Complication, Young dong