Abstract: Tsutsugamushi disease is an acute natural infectious disease caused by Orientia tsutsugamushi. The clinical manifestations are diverse and non-specific, resulting in easy to miss diagnosis and misdiagnosis. In this paper, the progress in the research of tsutsugamushi disease was reviewed, and a case of tsutsugamushi disease with multiple organ dysfunction was reported, aiming to improve the clinical diagnosis and treatment level of tsutsugamushi disease, especially severe cases. In terms of epidemiology, tsutsugamushi disease in China can be divided into summer type and autumn type. The cases have been reported all over the country and the incidence is increasing year by year. Cases have occurred in all ages and are mainly outdoor workers. Clinical manifestations include high fever, rash, eschar and multiple organ dysfunction. The traditional diagnostic methods are characterized by low positive rate and poor specificity. With the development of scientific research, the latest diagnostic techniques such as second-generation gene sequencing have been developed. In terms of treatment, general treatment, etiological treatment and supportive treatment are mostly adopted. Tetracycline drugs are effective antibiotics. When multiple organ function injury occurs, support technologies such as mechanical ventilation, blood purification and artificial liver can improve the efficacy.

Key words: Tsutsugamushi disease, Eschar, Multiple organ dysfunction, Next-generation sequencing