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Chonnam Med J. 1995 Jun;31(1):151-164. Korean. Original Article.
Lee JJ , Yeum CH , Chung YJ , Lee SC , Kim SW , Kim NH , Choi KC , Kang YJ .
Department of Internal Medicine, Chonnam National University Medical School, Kwangju, Korea.
Abstract

Fifty-two cases of hemorrhagic fever with renal syndrome who were diagnosed by serologic test from January 1988 to December 1994 at Chonnam University Hospital were retrospectively reviewed for the evaluation of epidemiological and clinical findings. The results were as follows: 1. The peak incidence was in 1994 (23.1%), annually increasing tendency, and on November (44.2%). 2. In distribution by age and sex, 14 cases (27%) were fifties, 13 cases (25%) in forties, and 12 cases (23%) in thirties, and male to female ratio was 1.6:1. 3. The most prevalent epidemic area was Young Kwang Goon in 8 cases and most susceptible occupation was farmer in 37 cases (71%). 4. The mortality rate was 11.5%. 5. Clinical symptoms were characterized by fever (98%), chill (85%), nausea (67%), vomiting (65%), myalgia (63%), abdominal pain and diarrhea (50%), and cough (50%). 6. On physical examination, conjunctival injection (71%), abdominal tenderness (56%), soft palate injection (40%), generalized edema & facial edema (16%), costovertebral angle tenderness (29%), facial flushing (25%), and petechia & purpura (23%) were found. 7. Laboratory findings on admission 1) Hemoconcentration was seen in 17%, leukocytosis in 89%, thrombocytopenia in 85% of cases. 2) Proteinuria was seen in 85%, hematuria in 79% of cases. 3) Bloody chemistry findings were characterized by increased BUN and serum creatinine (96%), increased AST (87%), hypoalbuminemia (71%), hyponatremia (69%), hypocalcemia (63%), increased ALT (56%), and increased LDH (27%). 4) The serologic diagnosis was confirmed with Hantadia kit by high density particle (HDP) agglutination and disclosed the cross reaction between Hantanvirus and Tsutsugamushi or Leptospira in 6% and 4% of cases. 8. Clinical stages of the patients on admission were as follows; febrile stage in 6 cases (12%), hypotensive stage 7 cases (14%), oliguric stage 32 cases (62%), diuretic stage 3 cases (6%), and transformed hypotensive stage to oliguric stage in 3 cases (6%). The mean duration of each stage was as follows; febrile stage 5.1 days, hypotensive stage 1.7 days, oliguric stage 4.9 days, and diuretic stage 10.9 days.

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