쯔쯔가무시 뇌막염과 관련된 예측인자들에 관한 연구

Abstract

Background Scrub typhus is febrile zoonosis resulting from infection with Orientia tsutsugamushi. Although scrub typhus has been treated successfully with the introduction of effective antibiotics, life-threatening serious complications including interstitial pneumonia, ARDS, ARF, myocarditis, meningoencephalitis, septic shock are still reported. The aim of this study is to report case series of scrub typhus with meningitis and evaluate predictable factors for meningitis. Methods One hundred and fifty patients who were diagnosed as scrub typhus at Chosun university hospital from 2004 to 2006 were enrolled. We procedured spinal tapping among who had mental change, severe headache, and divided meningitis group and non-meningitis group, and try to find predictable factors for meningitis. Result The development of mentational change(58.3%) nuchal rigidity(61.5%) was greater in the meningitis group compared to the non-meningitis group. (p<0.01) LDH was significantly higher in the non-meningitis group than the meningitis group, with level of 877.0±275.6 and 719.8±146.3, respectively. (p=0.045) Conclusions Mental change and nuchal rigidity are useful factors in predicting the development of meningitis with scrub typhus. Further prospective study with a larger population is needed to evaluate predictable factors.