Abstract | OBJECTIVE:
Tsutsugamushi disease ( scrub typhus) is caused by Orientia tsutsugamushi, and has been endemic in Asia and Western Pacific islands. Though sporadic case reports have described the clinical consequences of this vector-borne disease, data on the actual incidence of complications or mortality are scarce. It also remains unclear how a delay in effective treatments affects the occurrence of complications associated with this Rickettsial disease. METHODS: Using the Japanese Diagnosis Procedure Combination inpatient database in Japan, we identified patients with Tsutsugamushi disease between July 1 and December 31 in 2007 and 2008. We examined location of hospitals, patient's age, sex, comorbidities, complications, inhospital deaths, date of admission, date of starting therapy with tetracyclines. A logistic regression was conducted to analyze the association between delay in effective treatments and the occurrence of complications. RESULTS: A total of 210 cases were identified. Overall, 29 (13.8%) had at least one complication and two deaths were identified. Age was a significant risk factor for complications [odds ratio (OR), 1.48; 95% confidence interval (CI), 1.08-2.03; p=0.014, for a 10-year age increase]. Patients with ≥2 days delay in treatment with tetracyclines had a significantly higher risk of complications compared to those with no delay (OR, 2.71; 95% CI, 1.03-7.12; p=0.044). CONCLUSION:
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Authors | Hideo Yasunaga, Hiromasa Horiguchi, Kazuaki Kuwabara, Hideki Hashimoto, Shinya Matsuda |
Journal | Internal medicine (Tokyo, Japan)
(Intern Med)
Vol. 50
Issue 1
Pg. 37-42
( 2011)
ISSN: 1349-7235 [Electronic] Japan |
PMID | 21212571
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Tetracyclines
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Topics |
- Adolescent
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(administration & dosage)
- Child
- Comorbidity
- Databases, Factual
(statistics & numerical data)
- Delayed Diagnosis
- Female
- Humans
- Japan
(epidemiology)
- Logistic Models
- Male
- Middle Aged
- Risk Factors
- Scrub Typhus
(complications, diagnosis, drug therapy, epidemiology)
- Tetracyclines
(administration & dosage)
- Time Factors
- Young Adult
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