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KMID : 0383820090660020116
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Tuberculosis and Respiratory Diseases
2009 Volume.66 No. 2 p.116 ~ p.121
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A Correlation between Pulmonary Involvement of Acute Febrile
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Kim Go-Woon
Hyun In-Gyu
Lee Chang-Youl
Hong Won-Ki
Lee Myung-Goo
Lee Woo-Jin
Lee Sung-Hoa
Jung Ki-Suck
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Abstract
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Background: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent
diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases
remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic
episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of
infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients
with acute febrile illnesses.
Methods: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi,HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographicimages were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission.
Results: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients
had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had
pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had
interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and
a higher CRP level than that of those patients without pulmonary involvement (p=0.0073).
Conclusion: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP
level. Identification of this factor on admission might provide useful selection criteria for the patients who need
early intensive care.
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KEYWORD
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Tsutsugamushi, Leptospirosis, Hemorrhagic fever with renal syndrome, Pumonary involvement
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