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      • 소아 쭈쭈가무시병환자 28명의 임상상 및 유병기간에 따른 간접면역형광항체가의 변동상

        박병규,오영균,윤희상,염명걸,유한욱,김재형,강환섭,김익상,장우현,김승환 대한감염학회 1993 감염 Vol.25 No.2

        During the autumn of 1990 , we had investigated the clinical featuresw and followed the change in the direct immunofluorescent antibody(IFA) titers in 28 children with scrub typhus who resided in or near Chinju, Korea. All the children except one were diagnosed by the peak IFA titers of 1:160 or higher. The results were as follows: 1) The clinical features of our children were not different, to a large degree, from those of adults ever described in Korea literatures. But the frequence rates of skin rash, eschar and conjunctival injection were higher, those of proteinuria and hematuria were lower than those in adults and the characters of rash in our children were also quite different(faces were frequently the first site of eruption and even palms and soles were involved occasionally, initial bright red color of rash was changed into brown color during the acute phase). 2) IFA titers rose rapidly during the 2nd or 3rd week of illness and then formed plateau. When we suggest IFA titers of 1:180 or higher as the diagnostic criteria, the seropositivity of our children was 5/7(75%) in the 1st week and over 95% in the 2nd through 5th week of illness, and suggest IFA titers of 1:160 or higher,then the seropositivityin the 1st, 2nd and 3rd through 5th week were 3/7(43%), 23/31(74%) and over 95%,respectively. 3) IFA titers in 6-8 months after disease onset were 1:80(13 children) or 1:20( 7 children), and in one and half year (our longest follow-up period), 1:20 (3 children) showing that IFA lasts longer than one and half year after sickness. 4) From the above data (3) and the fact that majority of cases of scrub typhus occur in the autumn season in Korea, IFA titers of 1:40-1:160 should be used as the diagnostic criteria in order to distinguish between the present and past infections.

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