A case of tsutsugamushi disease rapidly diagnosed with polymerase chain reaction (PCR)

A 51-year-old man went mandarin orange picking near Lake Hamanako in Shizuoka Prefecture 15 days before the initial consultation to our hospital, followed by fishing at a pond in Nagoya City, Aichi Prefecture. He developed high grade fever and headache 5 days after fishing. When he visited our hospital, he had fever of 38 ^°C, headache, faint erythema on the trunk and extremities, a crust bite mark on the left lower leg, and enlarged lymph nodes in both inguinal regions. We suspected tsutsugamushi disease ; therefore, a blood sample was subjected to PCR. Kawasaki genotype was identified. Close to full recovery was achieved after a two-week treatment with minocycline hydrochloride initiated at the initial consultation. When we see a patient with fever and eruptions, it is necessary to keep in mind the possibility of tsutsugamushi disease. It is important to make a rapid diagnose with PCR and start medical treatment in this disease.