Abstract
A 54-years-old man, who had traveled to Niigata Prefecture, was diagnosed as tsutsugamushi disease based on elevated serum antibody level and a sticked scar in his thigh.
He suffered from prolonged fever and generalized exanthema followed by jaundice and anemia and died two months later.
At autopsy, mild lymphadenopathy and hepatosplenomegaly were found.
Microscopic examination showed focal monocytic infiltration as well as epitheloid cell granuloma in the heart and kidney. Old and recent angiitis were found in the kidney, digestive mucosa and testis. Cytomegalovirus infections and virus-associated hemophagocytosis were also observed.
