Investigation of 62 Tsutsugamushi Disease cases in Hiroshima City Asa Hospital

Abstract

We introduce the representative case of Tsutsugamushi disease that we recently experienced and report the characteristics of clinical symptoms and clinical findings of 62 cases experienced in 10 years (from 1998 to 2007), in Hiroshima City Asa Hospital. Mean age was 52.2 years (range4-84), and 34 were males and 28 were females. 58 patients (93.5%) were infected during October to December. 51 (82.3%) patients lived in Asakita-ku in Hiroshima city. 49 cases (79.0%), patients first visited department of internal medicine. Fever was observed in all cases, and eruption was observed in 61 cases (98.4%). Eschars were determined in 53 cases (85.5%), and swelling of lymph nodes were observed in 41 cases (66.1%). Fever came before eruption in most of the cases including 50 (88%) out of 57 cases. The time during fever and eruption was an average 3.5 days. As the abnormalities in laboratory values, of the 59 cases examined on peripheral blood smear, atypical lymphocytes were detected in 48 cases (81.4%). Liver dysfunction (high values of GOT or GTP) was observed with high rate in 57 cases (91.9%). On the other hand, decrease of platelets was observed only in 10 cases (16.1%) and no case developed disseminated intravascular coagulation. All cases quickly alleviate fever after the appropriate treatment, and an average from treatment to alleviate fever was 1.5 days. These findings may be helpful for next medical treatment.