| A Clinical Study of Tsutsugamushi Disease in Children |
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Jee Yeon Song, Ji Whan Han, Sung Soo Hwang, Kyung Yil Lee, Kyong Soo Lee |
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Department of Pediatrics, Catholic University Medical College, Seoul, Korea |
| 대전 및 충청지역에서 발생한 소아 쯔쯔가무시병의 임상적 고찰 |
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송지연, 한지환, 황성수, 이경일, 이경수 |
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가톨릭대학교 의과대학 소아과학교실 |
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| 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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