A Case of Tsutsugamushi Disease in Pregnant Woman

Kim, B C; Kim, J H; Park, C S; Han, S G; Kang, H A; Lee, K N

Abstract

Tsutsugamushi disease is one of the causes of acute febrile disease prevalent during fall season, like nephrotic syndrome, hemorrhagic fever, leptospirosis and Q-fever. Especially when tsutsugamushi affects a pregnant woman it should be differentiated from acute pyelonephritis, upper respiratory tract infection, etc. In our case, a woman with pregnant 22 weeks of gestation was admitted because of URI like symptoms such as fever, chillness, headache and myalgia. On her right flank an eschar which was characteristic of Tsutsugamushi disease was found. Her Tsutsugamushi antibody titer which was measured by serologic indirect fluoroimmunoassay was 1: 2560. Antibiotics(P.O. medication for 7-14days) such as tetracycline, doxycycline and chloramphenicol bring excellent effect to the treatment of the tsutsugamushi disease. But such medications however may cause several side effects to a fetus. The possible side effects require us to take a careful consideration as we prescribe such medications to a pregnant woman. In our case, it was found that the symptoms such as fever, chillness, headahe and myalgia which the patient carried at her first stage were disappeared after treating her with amoxicillin i.v. injection and roxitrol(macrolide antibiotics) p.o.medication. She was recovered in general conditions and finally discharged from hospital after 10 days.