급성 A형 간염과 쯔쯔가무시병의 비교 연구

Abstract

(Purpose) The prevalence rate of both acute hepatitis A and scrub typhus is rapidly increasing in Korea. The initial presentation of them consist of nonspecific symptoms such as fever, chillness, headache, and nausea. The purpose of this study is to achieve a faster differential through epidemiological, clinical and laboratory findings.

(Method) 104 acute hepatitis A patients and 197 scrub typhus patients between January 2005 and August 2008 were analyzed retrospectively through medical records.

(Result) The reports of nausea, vomiting, abdominal discomfort, jaundice and hepatomegaly in acute hepatitis A patients and febrile sensation, chillness, headache, anorexia reported in scrub typhus patients were statistically significant. The laboratory findings of increased number of white blood cell count(WBC), chronic reactive protein(CRP) were observed in scrub typhus patients. Increased aspartate aminotransferase(AST), alanine aminotransferase(ALT), lactate dehydrogenase(LDH), ALT/LDH ratio, γ-glutamyl transpeptidase(γ-GTP), bilirubin, prothrombin time(PT) reported in acute hepatitis A patients were statistically significant.

(Conclusion) The authors believe meticulous history taking, physical examination with laboratory findings(AST, ALT, LDH, ALT/LDH, bilirubin, etc) will help differentiate between hepatitis A and scrub typhus rapidly.

Key word : hepatitis A, scrub typhus, differential diagnosis.