Tsutsugamushi disease in Okayama prefecture: A case report after three years of no reported cases *
Tsutsugamushi disease can be treated with antibiotics with a good prognosis, if a diagnosis of Tsutsugamushi disease is made during the early stage. However if treatment is delayed by an incorrect diagnosis, death may occur in some patients with Tsutsugamushi disease. We experienced a case of Tsutsugamushi disease in Okayama Prefecture, although no cases of the disease had been reported in here for the past three years. A 57 -year-old woman visited our office after three days of chills, joint pain, headache, and a fever. She was treated as if she had a cold. On the next day, however, she still felt ill and consulted a dermatologist due to a rash. The dermatologist found an eschar on the her left neck and referred her back to us with a diagnosis of a possible case of Tsutsugamushi disease. She was admitted to our hospital for further evaluation and treatment. The patient's sera in the convalescent period showed an elevation of antibodies to Orientia tsutsugamushi. Intravenous administration of minocyclin improved her symptoms, and she was discharged to home without any complications after nine days' stay in our hospital. There have been an increased number of cases of Tsutsugamushi disease in many areas of Japan. Tsutsugamushi disease should be included as one the possible cause of febrile disease, especially when patient has an eschar and a rash, as our patient here in Okayama Prefecture did. (Acccptcd on December 28, 2000) Kawasaki Igakkaishi 27 (2 ) : 133 - 137, 2001
