Background:
@EN As tsutsugamushi disease is one of the endemic febrile illness during fall season in Korea, it is necessary to distinguish clinically tsutsugamushi disease from leptospirosis or hemorrhagic fever with renal syndrome for early adequate
treatment.
@ES Methods:
@EN One hundred and twenty cases of tsutsugamushi disease were analyzed clinically and epidemiologically, which were diagnosed at Chonnam University hospital, Kwangju Hankook hospital, Mokpo hospital, Sooncheon hospital and Yeonggwang hospital in
Chonnam province from 1990 to 1993.
@ES Results:
@EN: 1) For one hundred and twenty cases, the age distribution ranged from the wtenties to eighties and the disease was most common in the 6th decade(32.5%), 7th decade(21.6%) and 8th decade(21.6%). Male to female fatio was 1:1.3. The monthly
distribution rate was highest in November(53.4%), followed by 40.8% in October, 3.3% in December, and 2.5% in September.
2) The percentages of frequency of major symptoms were as follows: fever and chills, 83.9%; headache, 55.8%; myalgia, 55.0%. Eschar, rash and conjunctival injection were present in 75.0%, 52. 5% and 15.8%, respectively.
3) Abnormal liver function test, chest X-ray, and EKG were presen+ in 75.0%, 17.5% and 23.3% respectively. The serologic diagnosis was made by indirect immunofluorescent antibody test in 70% of cases;serologic cross reactions with Hantavirus of
Leptospira in 3.4% and 1.7% of cases, respectively.
4) All of the patients were satisfactorily cured with doxycycline. However, ht uncommon complications were myocarditis in one case and Guillain-Barre syndrome in two cases, which were recovered without sequelae.
@ES Conclusion:
@EN Tsutsugamushi disease is an acute febrile illness which is characterized by fever, chills, headache, myalgia, rash and eschar during autumn. Therefore, we have to make every effort to make early clinical diagnosis and to start empirical
treatment
before the serologic diagnosis.
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