In Korea, tsutsugamushi disease is a common acute febrile illness during autumn and about two thousand cases occur annually. Tsutsugamushi disease is caused by R. tsutsugamushi which invade endothelial cells and thereby cause systemic vasculitis.
Serious
manifestations are myocarditis, meningoencephalitis, interstitial pneumonitis, coagulopathy and acute renal failure.
We report a serologically proven case of tsutsugamushi disease which took a rather serious clinical course of massive pulmonary hemorrhage and meningoencephalitis, accompanied by focal neurologic signs, but without any skin rash, eschar or
lymphadenopathy.
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