The initial symptoms of tsutsugamushi are acute high fever, with a body temperature of 39.0℃ or more, accompanied by obvious symptoms of infection intoxication, poor appetite, weakness, nausea, vomiting and general fatigue. Some patients may have severe headache, and some patients may have rash, mainly on the trunk and neck, and some may have conjunctival congestion. Some patients may have a skin rash, mainly on the trunk and neck, and some may have a congestion of the conjunctiva. Lymph node enlargement and scabbing may appear at the site of the chigger mite bite. As the disease progresses, some patients may show symptoms of other systems, such as the nervous system, circulatory system, respiratory system, etc. Some patients may show symptoms such as gastrointestinal bleeding.