• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.188-191
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• 2003

Tsutsugamushi fever is a serious febrile disease outwardly similar to malaria and various arboviral infections. The endemic area is Asia-Pacific. This disease are generally associated with disturbed habitats favoring large populations of vector larval trombiculid mites. Therapy with tetracycline, chloramphenicol or ciprofloxacin is currently recommanded. Unfortunately these drugs is suboptimal for children and pregnant women. Recently, azithromycin has been proven to be effective in therapy of scrub typhus. There is no evidence that azithromycin causes adverse reaction to developing fetus or children. We report four cases of tsutsugamushi fever in children successfully treated with azithromycin. This is the first report describing clinical application of azithromycin to tsutsugamushi fever in Korean children.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.177-184
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• 2004

Objectives: Tsutsugamushi disease is one of the most significant acute febrile illnesses, increasing in frequency of occurrence during the late autumn in rural areas of Korea. Methods: I have conducted a case-control study on 30 cases who had the fever as a chief complaint, then had been ruled out as having the Tsutsugamushi disease. Data was collected retrospectively by review of chart regarding their general characteristics, clinical and laboratory findings, then was analysed by chi-test. Results: Of 30 cases, 16 cases were seropositive and 14 cases were seronegative against O. tsutsugamushi. Of seropositive for tsutsugamushi disease, 56.3% were female; 37.5% were in their seventies; 50.0% were farmers; 62,6% had chances of exposure to fields or mountains. And 75.0% occurred in November. The main symptoms and signs were fever and chill(100.0%), headache(75.0%). weakness and fatigue(93.8%), and eschar(68.8%). The characteristic laboratory findings were elevated AST(50.0%), ALT(62.5%), and abnormal urinalysis(56.3%). On the other hand, of seronegative cases, 57.1% were male; 50.0% were in their fifties; 42.9% were farmers; 57.2% had chances of exposure to fields or mountains. And 71.4% occurred in November. The symptoms and signs were fever and chill(100.0%), headache(85.7%), eschar(64.3%). weakness, fatigue and skin(57.1%). The laboratory findings were elevated AST(71.4%) and ALT(64.3%), and abnormal urinalysis(42.9%). However, there were no significant differences between the seropositive and seronegative cases(P>.05). Conclusions: Acute febrile community inhabitants who have the epidemiological, clinical as well as laboratory features should be focused upon for the early diagnosis and treatment for tsutsugamushi disease whether or not possessing the serological antibody against O. tsutsugamushi.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.119-128
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• 1994

This study was performed on 302 cases of leptospirosis, tsutsugamushi disease and hemorrhagic fever with renal syndrome(HFRS) which occurred in Chonnam(Do) in 1991 through 1993. The results were as follows : 1. 81.8% of the patients with Leptospirosis and 54.5% of the HFRS patients were men while 61.4% of the patients with tsutsugamushi disease were women. 2. Most patients lived in rural areas(Gun), their educational level was elementary School or lower and their occupations were either farmer or jobless. 3. Peak ages were 40s for leptospirosis(36.4%) and 50s for tsutsugamushi disease and HFRS(32.9% and 36.4% respectively). 4. The high incidence areas of tsutsugamushi disease were northern, eastern and a diagonal line, from northeast to southwest, of the Chonnam area, and these are consistent with a mountainous district. 5. In monthly distribution leptospirosis was higher in Sep. and Oct., and tsutsugamushi disease and HFRS were higher in Oct. and Nov. 6. The first case is occurring and the last case shows up later than in past years.

• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.35-44
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• 2003

Objectives : Though Tsutsugamushi disease has been reported with increasing frequencies in rural communities in Korea, it is not easy to find the nursing investigations. Methods : We have conducted a survey on 30 cases who had the fever as a chief complaint, then clinically ruled out the Tsutsugamushi disease in autumn of $2000{\sim}2001$. Data were collected retrospectively by investigation of the general characteristics, clinical and laboratory findings, their nursing care. Findings: Of 30 cases, 46.7% were farmers, and 60.0% had chances of exposure to fields or mountains. The characteristic symptoms and signs were febrile sense and chill(100.0%), headache(80.0%), and eschar(66.7%). Abnormal laboratory findings were anemia (23.3%), elevated AST(60.6%), ALT(63.3%), and abnormal urinalysis findings(50.0%). 53.3% were serologically confirmed as Tsutsugamushi disease. Therapeutic nursing cares were composed with warm up by blancket(50.0%), Ice bag(50.0%) and doxycycline antibiotic therapy(100.0%). Other nursing care for them included fluid therapy(100.0%) and nutritional support with regular(56.7%) or soft diet(43.3%). Conclusion: The above results indicate nurses who take care of acute febrile clients should make her responsible for the fever and pain management as well as give education for infection control for the community inhabitants.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.304-312
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• 2012

In this study, for behavior clinical signs and blood tests when autumn sudden fevered disease, Tsutsugamushi Disease is Single infected with mixing hemorrhagic fever with renal syndrom.221 positive patients, who have antibody titer more than 1:80 in serologic examination of Tsutsugamushi Disease in a general hospital, Jeollanam-do province, were adopted as a Analysis. in respect of frequency. Single infection patients of Tsutsugamushi Disease were 183 and mixed infection patients with Hemorrhagic Fever with Renal Syndrome were 38. In respect of age, patients over the 70's were mostly infected. In respect of sex, male patients were 70(31.7%) and female patients were 151(66.8%) Women were more infected than men. In respect of outbreak time, the more than 70% disease occurrence of all was charged in October and November and it also occurred in spring. In the clinical signs, fever(p=0.028), urtication(p=0.000) and muscle pain(p=0.000) of mixed infection was more higher than single infection. And in the blood tests, AST(p=0.000), ALT(p=0.000), blood urea nitrogen(p=0.002), total bilirubin(p=0.000) value of mixed infection was more higher than single infection.

• Journal of agricultural medicine and community health
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• v.17 no.2
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• pp.93-102
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• 1992

The epidemic of tsutsugamushi disease, along with hemorrhagic fever with renal syndrome(HFRS) and leptospirosis, has been ingrowing concern as it occupies a considerable proportion of the so-called seasonal febrile illnesses in autumn in Korea. This study was conducted to describe certain epidemiologic characteristics of the reported cases of the tsutsugamushi epidemic in Chollanamdo province in 1991. The findings could be summarized as follows: 1. Among three seasonal febrile illnesses in Autumn, tsutsugamushi disease occupied 91.9 percent of whole serologically confirmed cases. 2. Male-female sex ratio was 1 : 1.8. Majority of cases (77.4% in men, 65.1% in female) were in older age group (>=50 year of age). 3. Date of disease onset were distributed between late September and November. The 67.4% of cases were developed from October 21 to November 10, 1991. 4. The 41.5% of cases were reported from southern maritime districts. Reported dates of index cases and median cases were earliest in inland districts followed by southern maritime and latest in western maritime districts. 5. Most frequently reported clinical symptoms were chill (100%), high fever (100%), headache (81.7%), and skin eruption (70.4%).

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.292-299
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• 2000

We experienced two cases of Tsutsugamushi disease which occurred in October, 2000. The patients, who were over 70 years old and living in a rural area, visited Wonkwang University Oriental Chonju Medicine Hospital because of suffering fever, chill, skin rash, abdominal discomfort, and general weakness for a duration of seven days. The diagnosis was confmned as Tsutsugamushi disease by clinical findings such as eschar and high antibody titers on Reverse Passive Hemagglutination(RPHA). As for treatment, we used Sengmagalgentang-gamibang during the acute and Chojungikitang during convalescent phases of the illness. The patients were treated with Doxycycline of western medicine. The patients improved within 3 days of admission and were discharged within one week.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.213-221
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• 2001

Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

• Biomedical Science Letters
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• v.13 no.4
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• pp.287-291
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• 2007

The factors and mechanisms by infection of Oriental Tsutsugamushi caused disease are not well understood. The onset of tsutsugamushi disease is characterized by chilliness, fever, malaise, headache and generalized aching. Infection of tsutsugamushi is the cause of impairment of function of a major organ often complicate the picture and immediately change the prognosis for the worse. Tsutsugamushi disease is reported that this disease is characterized by the histopathogenesis of liver, kidney, heart, and lung, but the variation of biochemical components in serum of tsutsugamushi disease patient are not clear. We analyzed total protein (TP), albumin (AL), aspartic aminotranferase (AST), alanine aminotransferase (ALT), alkaline phosphotase (ALP), urea nitrogen (UN), creatinine (CRE), glucose (GLD), cholesterol (CHOL) and total bilirubin (TB) in sera of patients with tsutsugamushi disease. In comparison with reference, total protein and albumin were abnormally decreased in 19.6% and 39.2% of patients, respectively. AST, ALT, ALP, creatinine, UN, glucose, cholesterol and total bilirubin were abnormally increased in 94.1 %, 72.5%, 25.5%, 15.7%, 9.8%, 62.7%, 25.5% and 6.0% of patients, respectively. The patients showed abnormal relative rate of protein electrophoretic fractions to total protein in serum compared to them of reference were 43.1% (albumin), 12.9% ($\alpha_1$-globulin), 58.8% ($\alpha_2$-globulin), 60.8% ($\beta$-globulin) and 70.6% ($\gamma$-globulin), respectively. These data suggest that infection of Oriental Tsutsugamushi causes impairment of function of a major organ and abnormal serum protein electrophoresis fractions to tsutsugamushi patients.

• The Journal of Korean Oriental Chronic Disease
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• v.10 no.1
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• pp.32-38
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• 2005

Scrub typhus is a acute febrile illness by Orientia tsutsugamushi that is endemic in Asian-Pacific areas. It is characterized by fever, rash, eschar, lymphadenopathy. Therapy with Tetracycline, Doxycycline, Chloramphenicol is currently recommended. Here we report a case of tsutsugamushi disease in a 66 year old man had fever, nausea, vommitting, dyspnea, who was successfully treated with East-West intergrative medicine therapy - Antibiotics therapy and Korean traditional medicine(Sasang medicine and acupuncture treatment) - and symptoms improved.