Abstract: Objective:To investigate the clinical features and diagnosis of tsutsugamushi to provide the basis of treatment.Methods:The clinical data of 17 patients with tsutsugamushi were from October to November 2012 retrospectively analyzed.Results:Seventeen patients(including 16 farmers and 1 worker) had a history of contact with grassland and woodland.The varying degrees fever in 17 cases(100.00%),skin ulcers or eschar in 9 cases(52.94%),skin rash in 12 cases(70.59),liver injury in 14 cases(82.35%),renal injury in 8 cases(47.06%),splenomegaly in 2 cases(11.76%) and lymphadenovarix in 2 cases(11.76%) were found.The misdiagnosis rate was 47.06%.All patients cured after the treatment with azithromycin and/or levofloxacin.Conclusions:The clinical manifestations of tsutsugamushi is complex and diverse,and its misdiagnosis rate is high.Macrolides and quinolones are the most effective drugs in the treatment tsutsugamushi.The epidemic focus is founded in northern Anhui province.