Abstract: Objective To analyze the clinical characteristics of patients with tsutsugamushi disease, and provide the basis for scientific prevention and control of tsutsugamushi disease. Methods The clinical data of 77 cases of tsutsugamushi disease in Nanning infectious disease hospital from 2012 to 2020 were retrospectively collected. The epidemiological characteristics, clinical characteristics, laboratory examination, imaging examination, treatment and prognosis of the patients were analyzed. Results Among the patients with tsutsugamushi disease, the presence of fever and eschar/ ulcer accounted for 100%, with liver injury of 57.1%, kidney injury of 41.6%, central nervous system compromise of 5.2%, multiple organ function failure of 15.6%. There were 39 cases (50%) with eosinophilia, 65 cases (84.4%) with anemia, 67 cases (87%) with elevated C-reactive protein, 73 cases (94.8%) with elevated ferritin, 67 cases (87%) with increased ESR, 58 cases (75.3%) with decreased albumin, 60 cases (77.9%) with increased α-hydroxybutyrate dehydrogenase, and 64 cases (83%) with elevated lactate dehydrogenase. There were 61 cases (79.2%) with abnormal findings on chest imaging. The administration of Doxycycline, levofloxacin and azithromycin was effective treatment. Conclusion The clinical manifestations of tsutsugamushi disease varies, and could involve multiple organs. Fever, eschar or ulcer are the specific signs with the most diagnostic value. The course of disease is related to the incidence of organ injury. With timely and effective anti-bacterial treatment, this disease has a good prognosis.

Key words: Tsutsugamushi disease, Clinical characteristics, Guangxi region, Prognosis