Tsutsugamushi disease is an acute febrile systemic disease caused by Rickets tsutsugamushi and is characterized by fever, headache, skin rash and eschar. It is known as an endemic disease of Japan but is also found in South-eastern Asia and South Pacific Islands. Attention to tsutsugamushi is increasing as it has recently been known that tsutsugamushi disease is on the epidemic febrile disease in Korea that accounts for about 30% of acute febrile diseases, occurring in late fall, in one report.
We analyzed 17, clinically and serologically confirmed, tsutsugamushi disease cases occurring during the period of October-November, 1991.
Of 17 cases, 10 were males, and 7 were females and age distribution was from twenties to eighties, Nearly all patients has had chances of exposure to grass fields or scrubs and mostly farmers.
The main symptoms and signs were fever, chill(100%), headache(94%), myalgia(88%), skin rash(76%), crust(71%), cough(65%), anorexia(61%), sore throat(61%).
Serologically, 14 cases(82%) were confirmed by indirect immunofluorecent antibody test.
Common laboratory findings were elevated GOT/GPT(82%), alkaline phosphatase(41%), and hematuria(59%), proteinuria(47%).
On chest film, both lung field infiltration, mostly reticulonodular interstitial pattern, were seen in 5 patients(30%).
All the patients showed mild clinical course that the mean duration of improvement of subjective symptoms was 4.2 days with doxycycline oral therapy.
One patient who has had diabetes history was complicated by acute pyelonephritis and pleural effusion and had severely ill clinical course.