ABSTRACT
Tsutsugamushi disease is acute febrile illness, transmitted by Rickettsia tsutsugamushi. R. tsutusgamushi invade and proliferate in the endothelial cells of small blood vessels. Destruction of endothelial cells occurs from the proliferation of the organism and eventual disruption, and thus vascular rich organs must be carefully examined such as the kidney, lung, heart, liver. Recently we experienced a case of acute renal failure associated with R. tsutsugamushi infection in a child. Renal biopsy showed diffuse interstitial edema and mononuclear cell infiltration in the deep cortex. R. tsutusgamushi should be included as one of the causes of acute interstitial nephritis causing ARF in children, especially when the children have a acute febrile illness with rash in the fall and winter.