[Nasal bleeding as the first symptom of tsutsugamushi disease: a case report].

A case of 76-years-old male patient with nasal bleeding as the first symptom in our hospital, who was finally diagnosed as tsutsugamushi disease. This old man was bited by insect in farmland 2 days before the symptom occurred. PE: Left thigh and right buttock have eschar, with splenomegaly. Routine blood test: WBC (decrease) 3.9 x 10(9)/L, RBC (decrease) 3.86 x 10(9)/L, PLT (decrease) 41 x 10(9)/L, HGB (decrease) 117 g/L; Chest CT: lung interstitial pneumonia, a small amount of bilateral pleural effusion. Oxk-ag 1:320. The patient was discharged after treatment with chloramphenicol for 8 days.