title: A comparative study of hepatitis caused by scrub typhus and viral hepatitis A in South Korea.
abstract: We compared clinical features and laboratory findings of 104 patients with hepatitis A and 197 patients with scrub typhus. Nausea, vomiting, abdominal pain, hepatomegaly, and jaundice were common in patient with hepatitis A, and fever and headache were significantly more common in patients with scrub typhus. At presentation, an alanine aminotransferase (ALT) level ≥ 500 U/L was observed in 1% of scrub typhus patients and in 87.5% of hepatitis A patients (P < 0.001). A bilirubin level ≥ 1.3 mg/dL was observed in 16.8% of scrub typhus patients and 90.4% of hepatitis A patients. The ALT:lactate dehydrogenase ratio was ≤ 5 in 97.4% of the patients with scrub typhus and > 5 in 95.2% of those with hepatitis A (P < 0.001). Fever, headache, rash, and eschar are findings that indicate scrub typhus. An ALT level ≥ 500 U/L (adjusted odds ratio = 0.011) a bilirubin level ≥ 1.3 (adjusted odds ratio = 0.024), an ALT:lactate dehydrogenase ratio > 5, and hepatomegaly are indications of viral hepatitis A.
authors: Department of Internal Medicine, Research Center for Resistant Cells, School of Medicine, Chosun University, Gwangju, South Korea. joon3640@hanmail.net
authors: Jun
authors: J
authors: Lee
authors: Dong-Min
authors: DM
authors: Kim
authors: Na Ra
authors: NR
authors: Yun
authors: Yu Mi
authors: YM
authors: Byeon
authors: Young Dae
authors: YD
authors: Kim
authors: Chan Guk
authors: CG
authors: Park
authors: Man Woo
authors: MW
authors: Kim
authors: Mi Ah
authors: MA
authors: Han
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D006506:Hepatitis A / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012612:Scrub Typhus / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin