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Korean J Med > Volume 86(3); 2014 > Article
The Korean Journal of Medicine 2014;86(3): 301-307.
쯔쯔가무시 환자에서의 심전도 변화 및 임상 양상에 대한 고찰
김정민, 현미리, 김현아, 김미경, 김진영, 권기영, 류성열
계명대학교 의과대학 내과학교실
A Review of the Electrocardiography Changes and Clinical Manifestations of Scrub Typhus in a Single Center
Jeong Min Kim, Miri Hyun, Hyun Ah Kim, Mi Kyung Kim, Jin Young Kim, Ki Young Kwon, Seong-Yeol Ryu
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
Corresponding Author: Seong-Yeol Ryu ,Tel: +82-53-250-7915, Fax: +82-53-250-7994, Email: 121rsy@dsmc.or.kr
Received: May 22, 2013;   Revised: July 11, 2013;   Accepted: October 18, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Most scrub typhus patients have normal electrocardiography (ECG) findings. Recently, however, several cases with ECG changes were reported. However, few studies have examined the ECG changes in scrub typhus.
The ECG and demographic data of patients infected with Orientia tsutsugamushi seen at Dongsan Medical Center from January 2008 to June 2012 were reviewed retrospectively. Patients with pre-existing cardiac disease were excluded. The initial and follow-up ECG findings, demographic characteristics, and laboratory findings was examined.
The group in which the initial ECG showed an arrhythmia had a higher blood urea nitrogen (BUN) level than the normal and ischemic groups (median 26.0 vs. 15.0 vs. 15.5 mg/dL, p = 0.041). The group with a sustained abnormality in the follow-up ECG had higher BUN (median 17.0 vs. 15.0 mg/dL, p = 0.022) and creatinine (median 1.30 vs. 0.90 mg/dL, p = 0.026) levels than the normal ECG group. In addition, the group with a sustained abnormality in the follow-up ECG had a higher rate of intensive care unit (ICU) admission (30.8% vs. 5.3%, p = 0.015) and longer treatment period (average 9 vs. 6 days, p = 0.027) than the other groups.
In our study, more than 30% of the patients with scrub typhus showed ECG abnormalities. Those with an arrhythmic ECG change on presentation had high BUN levels. The sustained ECG abnormality group had high BUN and creatinine levels, and an increased ICU admission rate and length of stay. We should pay attention to the ECG findings on presentation and during the treatment of scrub typhus. (Korean J Med 2014;86:301-307)
Keywords: Scrub typhus; Orientia tsutsugamushi; Electrocardiography
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A Review of Electrocardiography Changes and Clinical Manifestations in Scrub Typhus in a Single Center  2014 March;86(3)
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