NEUROPSYCHIATRIC OBSERVATIONS ON TSUTSUGAMUSHI FEVER (SCRUB TYPHUS)

Abstract

ALTHOUGH records indicate that tsutsugamushi fever (scrub typhus, Japanese river fever, kedani fever, Japanese flood fever) has been known to exist for over a thousand years, the American medical profession had little experience with the disease until it was encountered among troops stationed in certain areas of the Southwest Pacific theater of the war. Tsutsugamushi, which is caused by Rickettsia nipponica (Rickettsia orientalis, Rickettsia tsutsugamushi), is widely distributed over an area which includes Japan, Malaya, French Indo-China, Sumatra, the Philippines, other islands of the Pacific and northern Australia. The disease will continue to be brought to the attention of physicians in the United States by returned soldiers who have residual manifestations and may again be encountered among the occupation troops in the islands of Japan. Numerous clinical investigations have been made since the first description of tsutsugamushi by Palm, in 1878. Although frequent references to neurologic and psychiatric manifestations of