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A Clinical Study of Tsutsugamushi Disease in Children

Journal of the Korean Pediatric Society 1995;38(5):641-648.
Published online May 15, 1995.
A Clinical Study of Tsutsugamushi Disease in Children
Jee Yeon Song, Ji Whan Han, Sung Soo Hwang, Kyung Yil Lee, Kyong Soo Lee
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
대전 및 충청지역에서 발생한 소아 쯔쯔가무시병의 임상적 고찰
송지연, 한지환, 황성수, 이경일, 이경수
가톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: Recently in Korea, there has been an increasing concern regarding Tsutsugamus-hi disease. This disease is increasingly reported in children. The purpose of this study was to c-onsider the possibility that Tsutsugamushi disease may be diagnosed as eruptive disease or F UO( fever of unknown origin)
Methods
: We reviewed 17 clinically or serologically confirmed cases of Tsutsugamushi dis-ease from Daejeon and Choongchung Province which occured during the period of October 19 90 to November 1993.
Results
: of the 17 cases studied, 11 cases(64.7%) were male and 6 cases(35.3%) were fe-male patients. The mean age of patients was 6.9 years, ranging from 6 months to 11 years. Th-irteen patients(76.4%) were from urban areas, and 4(23.6%) patients were from rural areas. Th e most common symotoms were fever & chills in all cases(100%), and headache in 10 cases(5 8%). The most common signs were skin rash in all cases(100%), eschar in 16 cases(94%), and regional lymphadenitis in 9 cases(52%). The main locations of the eschars were the inguinal area in 5 cases, the subdavian area in 2 cases, the lower abdomen in 2 cases, and the popliteal area in 2 cases. Laboratory findings included leukocytosis in 3 cases(17%), SGOT elevation in 5 cases(47%), SGPT elevation in 8 cases(94%), LDH elevation in 16 cases(94.1%), elevated E SR in 6 cases(35.2%), positive CRP in 15 cases(88.2%), positive passive hemagglutination tes t in 14 cases(82.3%). Clinical improvement was noticed in all cases after treatment with chlor- amphenicol or doxycycline. The mean duration form the start of the treatment to the defervesc-ence of fever was 1.5 days. The mean duration of the treatment was 7.4 days. There were no c omplications or recurrence in any case.
Conclusion
: We suggest that Tsutsugamushi disease can be diagnosed and treated succ- essfully based on the clinical sympotoms and signs only prior to serological confirmation.
Key Words: Tsutsugamushi disease, Children


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