title: Tsutsugamushi disease in Kanagawa Prefecture, Japan: clinical report of two cases and survey of other incidences in 1998.
abstract: Tsutsugamushi disease is characterized by the early appearance of a black crust at the bitten area and the subsequent development of macular or macropapular rush on the whole body with high fever. While treatment with tetracycline derivatives and chloramphenicols is effective, delayed diagnosis or inappropriate treatment will lead to fatality. In this report, we describe two typical cases of tsutsugamushi disease and discuss other incidences in Kanagawa Prefecture, Japan, in 1998. One of the present two patients was diagnosed to be a case of the new type by Kawasaki strain of Rickettsia tsutsugamushi, while responsible strain was not identified for the other case. Since the disease is spreading widely even to suburban areas, we emphasize the need to consider the possible diagnosis of tsutsugamushi disease in patients with generalized eruption and high fever.
authors.affiliation: Department of Dermatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ozaki
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: K
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: M
authors.initials: M
authors.lastname: Iizuka
authors.forename: K
authors.initials: K
authors.lastname: Urano
authors.forename: Y
authors.initials: Y
authors.lastname: Kawakubo
authors.forename: S
authors.initials: S
authors.lastname: Kanno
authors.forename: A
authors.initials: A
authors.lastname: Ozawa
authors.forename: M
authors.initials: M
authors.lastname: Ohkido
authors.forename: F
authors.initials: F
authors.lastname: Hirota
authors.forename: N
authors.initials: N
authors.lastname: Nagashima
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D011159:Population Surveillance; D012612:Scrub Typhus / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline