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1988 년 가을 강원도 영서지역에서 발생한 쭈쭈가무시병 24 예의 임상적 관찰
최동성(Dong Seong Choi),이광훈(Kwang Hoon Lee),박진현(Jin Hyun Park),신계철(Gae Chul Shin),조한선(Han Sun Jo),심영학(Young Hak Shim),윤갑준(Gap Jun Yun),백일기(Ill Ki Baek),임채선(Chae Sun Im),호휘남(Whi Nam Ho) 대한내과학회 1989 대한내과학회지 Vol.37 No.3
N/A We obserbed 24 cases of tsutsugamushi disease occur- ring in the Gang-Won-Do area from September to October 1988, which were confirmed by indirect immunofluorescent antibody test, and analysed their clinical findings. On physical examination eschars which can be a clinical clue to tsutsugamushi disease in the early stage of infection were recorded in 11 cases (45%). Common laboratory features included thrombocytopenia in 19 cases (95/o), and increased SGOT in 22 cases (92%), SGPT in 49 cases (79%), LDH in 19 out of 20 cases (95%) tested, CK in 7 out of 20 cases (35%) tested and serum ADA level in 12 of 13 cases (92%) tested. Serum fibrinogen was decreased in 5 of 13 cases (38%) tested, FDP was positive in 8 of 13 cases (62%) tested and prolonged prothrombin time was observed in 9 cases (38%). When IgM and IgG titers were measured separately, two distinct responses were seen. The IgM titers gradually declined during the period from 14-40 days. The IgG responses in the same patients developed more slowly. In our study, tsutsugamushi disease was a mild to severe febrile illness of 1 to 2 weeks duration. We think that more concern about tsutsugamushi disease is necessary because of possible mortality in poorly treated cases as well as a need for more precise differential diagnosis of acute febrile illness.