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KMID : 0377220030280010079
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Medical Journal of Chosun Univercity
2003 Volume.28 No. 1 p.79 ~ p.84
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Clinical Analysis and Hypoalbuminemia as Prognostic Factors in Tsutsugamushi Disease
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Park Chi-Young
Yim Hyun-Seong
Park Jun-Ok
Park Sang-Muk
Chung Choon-Hae
Kim Man-Woo
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Abstract
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Background and Objectives : In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 20~40% among acute febrile diseases during Autumn. It is characterized by a typical primary lesion(eschar), rash and non-specific symptoms such as fever and chill, headache and myalgia It shows widely varying clinical outcomes from subclinical infection to death Therefore, early diagnosis and treatment lead to rapid recovery. Otherwise, many complications may develop including acute renal failure, acute respiratory distress syndrome and sepsis. We investigated the clinical manifestations and prognostic factors of tsutsugamushi disease
Materials and Methods : We retrospectively reviewed the clinical manifestations and laboratory findings of the eighty four patients with tsutsugamushi disease who were admitted between October 1999 and October 2002 at Chosun University hospital.
Results : The characteristic clinical findings were fever and chill(96.4%), eschar(80.9%), skin rash(54.8%) and dyspnea(6%) Laboratory findings showed anemia(46.4%), thrombocymiddleenia(369%), abnormal liver function(90%) and elevated LDH(72.6%) Hypoalbuminemia was revealed in 32 patients(38.1%) These hypoalbuminemic patients showed significantly higher incidence of abnormal chest x-ray findings(62.5% vs 28.8%, p value 0.003), acute renal failure(32% vs 1.9%, p value 0.000), abnormal aPTT(46.9% vs 17.3%, p value 0.004) and prolonged hospital stay(10 days vs 7 days, p value 0.005) compared to normoalbuminemic patients. Three patients who had hypoalbuminemia died due to congestive heart failure, renal failure and sepsis.
Conclusion : Hypoalbuminemia may be used as a marker of the severity of disease in patients with tsutsugamushi disease
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KEYWORD
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Tsutsugamushi disease, Hypoalbuminemia
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