Tsutsugamushi disease

소개글

쯔쯔가무시에 관한 PPT 입니다

목차

Identification

Admission Note

Admission Note – Physical Examination

Admission Note – Review of System

Eschar

Abdominal rash

Admission Note – Initial Lab.

Admission Note – Radiologic Finding

Admission Note

Progress Note (2008.10.15)

DISEASE REVIEW

Epidemiology

Clinical Manifestations

Diagnosis

Treatment

본문내용

Admission Note
Chief Complaint
Epigastric pain & anorexia, fever for 10 days

Admission Note
Present Illness
2년전 LMC cholecystectomy Op.받은 환자로 최근 몇주일간 산에서 일하였으며, 10일간의 anorexia, nausia, feverile sensation, epigastric pain(dull nature), skin rash로 내원 3일전 LMC ER방문 후, Symptom호전 없었음.
내원 2일전 본원 ER방문하여서 시행한 evaluation상 Rt. Axillar에 eschar발견되어 Tsutsugamushi ds.의심되어 본과 admission함.

Admission Note
Past History
HTN/DM/Tb/Liver ds (+/-/-/-): 1년 전 진단
Familial History
U-R
Social History
Alcohol : none
Smoking : none

Admission Note ? Physical Examination
Vital sign
Blood pressure : 150/90 mmHg
Body temperature : 38.8 ℃
Pulse rate : 88 회/min
Respiratory rate : 20회/min
General appearance
Acute ill appearance

Admission Note ? Physical Examination
Head and neck
Conjunctivae : not pale/ injection(+)
Anicteric sclerae
Dried oral cavity
Neck vein distension(-)
Palpable mass(-)
Chest
Clear breath sound without rale
Regular heart beat without murmur

Admission Note ? Physical Examination
Abdomen
Epigastric Td./RTd. (+/-)
Rash (+)
Back & Extremities
Deformities(-)
Pretibial pitting edema(-)
CVA tenderness(+)

참고 자료

Harrison’s internal medicine, 17th edition
Cecil Medicine, 23rd edition