| Two Cases of Misdiagnosis of Acute Appendicitis in a Patient with Hemorrhagic Fever with Renal Syndrome and a Patient with Tsutsugamushi Disease. |
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Seo, Jung Pil , Kim, Young Ok , Choi, Yun Seok , Kim, Eun Il , Yoon, Sun Ae , Chae, Hyun Seok , Song, Sun Wha , Kim, Nam Il , Yoo, Seung Jin |
1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
3Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmckyo@cmc.cuk.ac.kr |
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| Abstract |
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Both tsutsugamushi disease and hemorrhagic fever with renal syndrome frequently cause abdominal pain with tenderness; therefore they are occasionally misdiagnosed as surgical abdomen. Two patients presented with symptoms of acute abdomen, and under the suspicion of acute appendicitis they underwent appendectomies. Nevertheless there were no operative findings of acute appendicitis in both patients, and the clinical conditions were deteriorated after the operation. Acute infectious disease was suspected by thrombocytopenia, elevated liver enzymes, and proteinuria.
Indirect immunoflourescence test confirmed tsutsugamushi disease and hemorrhagic fever with renal syndrome, respectively. The patient with tsutsugamushi disease improved with administration of doxycycline and the patient with hemorrhagic fever with renal syndrome spontaneously improved. |
| Key Words:
Tsutsugamushi disease; Hemorrhagic fever with renal syndrome; Abdominal pain; Acute appendicitis |
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