• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.71-73
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• 2009

Biclonal gammopathy is characterized by the presence of two different monoclonal immunoglobulins, and the clinical findings of biclonal gammopathy are similar to those of monoclonal gammopathy. An association between biclonal gammopathy and tsutsugamushi meningitis has not been reported previously. Here, we report a case of a 55-year-old man presented with fever and decreased mentality. A cerebrospinal fluid (CSF) test and an indirect immunofluorescent antibody test for Orientia tsutsugamushi revealed tsutsugamushi meningitis. CSF and serum immunofixation electrophoresis revealed biclonal gammopathy (IgG-${\kappa}$, IgG-${\lambda}$). His symptoms improved after antibiotics treatment, and serum biclonal gammopathy completely disappeared.

• The Journal of the Korean Society for Microbiology
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• v.35 no.2
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• pp.159-169
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• 2000

Scrub typhus is caused by Orientia tsutsugamushi characterized by fever, headache, lymphadenopathy and eschar formation. Infiltration of inflammatory cells around blood vessels and within the affected organs isS known to be pathologic hallmark of the scrub typhus. Recently, expression of adhesion molecules on vascular endothelial cells was implicated as an important pathogenic mechanism in rickettsial disease. This study was performed to examine the expression of adhesion molecules and to investigate its role in the pathogenesis of O. tsutsugamushi infection. The expression of adhesion molecules on human umbilical vein endothelial cells (HUVEC) was measured by flow cytometry and indirect immunofluorescence. Expression of E-selectin, ICAM-1 and VCAM-1 was significantly increased 4 hours after the infection and persisted at least for 24 hours. Expression of those molecules was not induced by killed O. tsutsugamushi. Adhesion of polymorphonuclear cells and mononuclear cells to HUVEC was increased after the infection with O. tsutsugamushi. In conclusion, adhesion molecules are expressed on HUVEC during the infection of live O. tsutsugamushi and those molecules can contribute to the infiltration of inflammatory cells during the infection.

• The Journal of the Korean Society for Microbiology
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• v.21 no.1
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• pp.113-120
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• 1986

In Korea 8 tsutsugamushi disease patients were reported among the United Nations Forces personnel during 1951-54, but the disease was not known among the native Koreans. In Chinhae, patients with fever, chills, headache and rash were observed in every late autumn to early winter for many years, but etiologic diagnosis was not made. In 1985, there were 34 such patients. The authors were able to determine the disease as tsutsugamushi disease by observing the pathognomic eschar in 4 patients and demonstrating antibodies against Proteus OXK and Rickettsia tsutsugamushi antigens in 21 patients. The patients were mostly females of over 30 years of age. It was considered that most of them contracted the infection while doing farm works or picnic at the outskirts of Chinhae city and the adjacent areas. They were treated with chloramphenicol and no fatalities were observed.

• Parasites, Hosts and Diseases
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• v.57 no.2
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• pp.167-173
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• 2019

Rickettsial infections (Rickettsioses) are the causes of acute fever found in Thailand. It is classified as acute febrile illnesses transmitted by bloodsucking arthropod vectors (tick, flea, and chigger). This research investigated pathogens of scrub typhus in vectors from Bangkaew District, Phatthalung Province. A total of 303 pools of vector samples were ticks (Rhipicephalus sanguineus, R. microplus, and Haemaphysalis sp.), fleas (Ctenocephalides felis orientis, C. f. felis, and C. canis), and chiggers (Leptotrombidium deliense, Aschoschoengastia indica, Blankaartia acuscutellaris and Walchia disparunguis pingue) collected from reservoir hosts (dogs and rodents). The 17 and 56 kDa gene of Rickettsia causing scrub typhus were found in 29% of ticks and 98% of flea. DNA sequence analysis reveeled the detected strains were R. asembonensis and Rickettsia sp. cf1 and 5.The chiggers, 1%, were infected with Rickettsia strain TA763, a pathogen of scrub typhus.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.151-163
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• 1990

Tsutsugamushi disease is an acute febrile disease caused by Rickettsia tsutsugamushi, and which has been reported with increasing frequency through the nation since 1986. We experienced 21 cases of Tsutsugamushi disease diagnosed with serologic test occuring in Taegu city and Kyungpook province during October-November, 1989. The results of survey are as follow. 1) Of 21 cases, 12(57%) were males and 9(43%) were females, and the peak incidence was the 4th decade. 2) The outbreak was in October to November and the peak incidence was in October. 3) The most frequent symptoms were fever and chill(100%), myalgia(95%), headache(90%). Eschar and rash were observed in 18 patients(86%) and the eschar was detected in all over the body, especially thorax(33%) and lower extremity(22%). 4) Laboratory features were SGOT elevation(83%), SGPT elevation(61%), LDH elevation(67%). leukocytosis (38%). 5) Indirect immunofluorescent antibody test was done m 18 patients and the antibody titer was above 1 : 320 in all patients. 6) The chloramphenicol, tetracycline or doxycycline regimens were very effective and mean duration of defervescence from iniation of therapy was 1.3 days. 7) The complication such as meningitis or shock, was not seen.

• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.31-41
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• 1989

Since the first cases of tsutsugamushi disease reported in Korea in 1986. many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are ; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills(88%), myalgia(65%), headache(54%), nausea and vomiting(31%), and abdominal pain(27%). The eschar was detected on lower part of body in most of cases. and more frequently in male(M : F 100 vs 58%). 4. Patients were treated with tetracyclines(TC) and/or chlorampenicol(CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1 days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 cases of shock. and all cases were recovered without any sequlae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

• Journal of the Korean Data and Information Science Society
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• v.20 no.1
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• pp.149-158
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• 2009

Tsutsugamushi fever occupies more than 80% of total fall epidemic diseases and has an incubation period of 1 or 2 weeks as well. We have assumed that the incubation period distribution is gamma and therefore, reach an agreement that the infected distribution is normal with ${\hat{\mu}}=309.92$, ${\hat{\sigma}}=14.154$ by back calculation method. The infection cases are found severely large around the month of October. The infection case distribution demonstrates the incidence number increasing rapidly and progresses fast during the month of November. In this study, we have calculated the future prevalence number of maximum 1,200 people by inferred infection probability and incubation period distribution with some sort of limitation that the trend of increasing incidence number is not taking into an account. We considered the SIRS model which is also known as epidemic model, familiar to interaction between epidemiological classes. Our estimated parameters converged well with the initial parameter values.

• Biomedical Science Letters
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• v.16 no.4
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• pp.311-316
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• 2010

We studied a comparison of the concentration of biochemical markers in sera of patients hospitalized with high fever (n=296) in Jeonbuk province during the last 2 years (2008 to 2009). The patients were divided into three patient groups of viral hemorrhagic fever (VHF) patient group tested positive for Hantavirus (n=53), leptospirosis (LEP) patient group tested positive for Leptospira interrogans (n=137) and scrub typhus (TSU) patient group tested positive for Orientia tsutsugamushi (n=106). We analyzed the concentration of ALP, AST, ALT, blood urea nitrogen, creatinine and glucose and compared the mean levels of them to normal range, the first sample and last sample. The frequencies of abnormal patient elevated above the upper limit of normal for ALP, AST and ALT were 18~43.4%, 78~97% and 62.3~92.7% in patient groups, and 24.5~47.4% (total protein) and 13.2~50.0% (albumin) of patients in patient groups had decreased below the lower limit of normal. The patients showed higher abnormal levels of glucose in patient groups were 58.5% (viral hemorrhagic fever patient group), 66.4% (leptospirosis patient group), 71.7% (scrub typhus patient group) and 66.9% (total patient group). There were significant difference between the first sample and the last sample in the mean levels of AST (decreased 22.2% in viral hemorrhagic fever patient group, 30.2% in leptospirosis patient group, 20.4% in scrub typhus patient group and 24.1% in total patient group), BUN (43.0% in viral hemorrhagic fever patient group, 41.6% in leptospirosis patient group, 47.4% in scrub typhus patient group and 43.0% in total patient group) and glucose (20.2% viral hemorrhagic fever patient group, 17.9% in leptospirosis patient group, 18.6% in scrub typhus patient group and 18.9% in total patient group) in the first sample and the last sample. According to these results, those diseases may cause liver damage and have high concentration of ALP, AST, ALT and glucose in blood even though the patients get out of the hospital.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.710-713
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• 2003

Purpose : Although chloramphenicol and doxycycline have been used for the treatment of tsutsugamuchi disease, a difficulty exists in determining which drugs to use in treating children because of potential complications such as aplastic anemia or teeth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on tsutsugamushi disease in children. Methods : A retrospective analysis was conducted on 39 children with tsutsugamuchi disease(scrub typhus) who were treated with doxycycline(DC), chloramphenicol(CM), or roxythromycin(RM) between 1991 and 2000. We divided the patients into a DC-treated group(DC group; 16 children), a CM-treated group(CM group; 14 children), and RM-treated group(RM group; 9 children) and compared these groups. Results : Most cases(97%) developed in October and November. Fever and rash were observed in all 39 cases and an eschar was noted in 36 cases(92%). No statistical differences could be found between the three groups in mean age, duration of fever before admission, white blood cell(WBC) count, and complications including abnormal liver enzymes. In most cases defervescence after treatment was within 24 hours(34 cases, 87%), and during 24-48 hours in two cases in the DC group, one in the CM group, and two in the RM group(no statistical difference). Conclusion : Roxythromycin was as effective as conventional doxycycline or chloramphenicol, in children with scrub typhus and may be safer to use.

• The Journal of Korean Society of Virology
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• v.28 no.4
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• pp.377-382
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• 1998

Hemorrhagic fever with renal syndrome (HFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against Otsutsugamushi, Rickettsia typhi, Leptospira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.