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KMID : 0384320020230010087
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Korean Journal of Family Medicine
2002 Volume.23 No. 1 p.87 ~ p.95
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A clinical research of tsutsugamushi disease occured in and around Jeoung-up in the autumn of 2000
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Kim Heyon-Sook
Kang Sang-Gun
Cha Mann-Jin
Jo Kwan-Ho
Hwang Hye-Hun
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Abstract
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Background: In korea, tsutsugamushi disease in one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy.
Methods: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October-November, 2000.
Results: Of 16 cases, 7 were males and 9 were females with an average age of 57.75. Most patients had fever, chill, headache, myalgia, sore throat, conjunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eschar (81.25%) and skin rash (62.5%). Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.5%), increased or decreased WBC (31.25% and 25% each other), and anemia (25%). Test for liver function included elevated AST, ALT (68.75%), alkaline phosphatase (62.5%), hypoalbuminemia (12.5%), and hyperbilirubinemia (6.25). Urinanalysis showed hematuria (50%), proteinuria (50%), and pyuria (12.5%). Doxycycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms.
Conclusion: Primary care physician in a community should always consider tsutsugamushi disease
when he encomunters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.
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KEYWORD
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tsutsugamushi diseases, eschar
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