A Comparative Study of Hepatitis Caused by Scrub Typhus and Viral Hepatitis A in South Korea

作者：Lee Jun; Kim Dong Min^*; Yun Na Ra; Byeon Yu Mi; Kim Young Dae; Park Chan Guk; Kim Man Woo; Han Mi Ah

来源：The American Journal of Tropical Medicine and Hygiene, 2011, 85(5): 873-877.

DOI：10.4269/ajtmh.2011.09-0703

We compared clinical features and laboratory findings of 104 patients with hepatitis A and 197 patients with scrub typhus. Nausea, vomiting, abdominal pain, hepatomegaly, and jaundice were common in patient with hepatitis A, and fever and headache were significantly more common in patients with scrub typhus. At presentation, an alanine aminotransferase (ALT) level >= 500 U/L was observed in 1% of scrub typhus patients and in 87.5% of hepatitis A patients (P < 0.001). A bilirubin level >= 1.3 mg/dL was observed in 16.8% of scrub typhus patients and 90.4% of hepatitis A patients. The ALT:lactate dehydrogenase ratio was <= 5 in 97.4% of the patients with scrub typhus and > 5 in 95.2% of those with hepatitis A (P < 0.001). Fever, headache, rash, and eschar are findings that indicate scrub typhus. An ALT level >= 500 U/L (adjusted odds ratio = 0.011) a bilirubin level >= 1.3 (adjusted odds ratio = 0.024), an ALT lactate dehydrogenase ratio > 5, and hepatomegaly are indications of viral hepatitis A.

• 出版日期2011-11