All issues > Volume 38(5); 1995

Original Article

J Korean Pediatr Soc. 1995;38(5):641-648. Published online May 15, 1995.

A Clinical Study of Tsutsugamushi Disease in Children

Jee Yeon JY Song¹, Ji Whan JW Han¹, Sung Soo SS Hwang¹, Kyung Yil KY Lee¹, Kyong Soo KS Lee¹

¹Department of Pediatrics, Catholic University Medical College, Seoul, Korea

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.

Keywords :Tsutsugamushi disease, Children