A Clinical Study of Tsutsugamushi Disease Associated with Acute Renal Failure

Kim, Byung soo; Kim, Young Ok; Song, Ho Cheol; Lee, Seung Hun; Kim, Suk Young; Choi, Eui Jin; Chang, Yoon Sik; Bang, Byung Kee

Abstract

BACKGROUND
Tsutsugamushi disease is one of the acute febrile illness frequently developed in Korea. Unless it is cared properly in acute stage, it can be progressed to severe status associated with complication such as acute renal failure (ARF). But there has been little reported about tsutsugamushi disease associated with ARF. METHODS: We investigated patients records with tsutsugamushi disease associated with ARF, who were admitted at Our Lady of Mercy's Hospital and Uijeongbu St. Mary's Hospital from 1994 to 2003. 6. RESULTS: The incidence rate for ARF was 14.1% (23/163). Most patients have fever but eschar which is one of the most important findings, appeared less than half patients. Hypotension during developed more frequently in severe ARF group than mild ARF (p<0.05). Platelet count at admission and lowest platelet count was significantly lower in severe ARF group (p<0.05). The mortality rate was 3/23. All of them are in severe ARF group (p<0.05). The highest creatinine level was positively correlated with AST (p<0.01) and ALT (p<0.01). CONCLUSION: Tsutsugamushi disease is an acute febrile illness which is not rare in Korea. With proper and early management, it can be cured. But as it can be progressed to severe state with complication such as ARF and death in some cases, it is important to diagnose early and manage carefully.