쯔쯔가무시 환자에서의 심전도 변화 및 임상 양상에 대한 고찰
A Review of the Electrocardiography Changes and Clinical Manifestations of Scrub Typhus in a Single Center
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Background/Aims: Most scrub typhus patients have normal electrocardiography (ECG) findings. Recently, however, several caseswith ECG changes were reported. However, few studies have examined the ECG changes in scrub typhus. Methods: The ECG and demographic data of patients infected with Orientia tsutsugamushi seen at Dongsan Medical Center fromJanuary 2008 to June 2012 were reviewed retrospectively. Patients with pre-existing cardiac disease were excluded. The initial andfollow-up ECG findings, demographic characteristics, and laboratory findings was examined. Results: The group in which the initial ECG showed an arrhythmia had a higher blood urea nitrogen (BUN) level than the normaland 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-upECG 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 thanthe normal ECG group. In addition, the group with a sustained abnormality in the follow-up ECG had a higher rate of intensive careunit (ICU) admission (30.8% vs. 5.3%, p = 0.015) and longer treatment period (average 9 vs. 6 days, p = 0.027) than the othergroups. Conclusions: In our study, more than 30% of the patients with scrub typhus showed ECG abnormalities. Those with an arrhythmicECG change on presentation had high BUN levels. The sustained ECG abnormality group had high BUN and creatinine levels, andan increased ICU admission rate and length of stay. We should pay attention to the ECG findings on presentation and during thetreatment of scrub typhus.
Abstract
Background/Aims: Most scrub typhus patients have normal electrocardiography (ECG) findings. Recently, however, several caseswith ECG changes were reported. However, few studies have examined the ECG changes in scrub typhus. Methods: The ECG and demographic data of patients infected with Orientia tsutsugamushi seen at Dongsan Medical Center fromJanuary 2008 to June 2012 were reviewed retrospectively. Patients with pre-existing cardiac disease were excluded. The initial andfollow-up ECG findings, demographic characteristics, and laboratory findings was examined. Results: The group in which the initial ECG showed an arrhythmia had a higher blood urea nitrogen (BUN) level than the normaland 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-upECG 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 thanthe normal ECG group. In addition, the group with a sustained abnormality in the follow-up ECG had a higher rate of intensive careunit (ICU) admission (30.8% vs. 5.3%, p = 0.015) and longer treatment period (average 9 vs. 6 days, p = 0.027) than the othergroups. Conclusions: In our study, more than 30% of the patients with scrub typhus showed ECG abnormalities. Those with an arrhythmicECG change on presentation had high BUN levels. The sustained ECG abnormality group had high BUN and creatinine levels, andan increased ICU admission rate and length of stay. We should pay attention to the ECG findings on presentation and during thetreatment of scrub typhus.
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