중환자실 발열의 원인-전향적, 코호트 연구

전은주,이혜민,조성근,강형구,곽희원,신종욱,송주한,정재우,최재철,박인원,최병휘,김재열 대한중환자의학회 2008 Acute and Critical Care Vol.23 No.1

Background: Fever develops in 70% of ICU patients. In the present study, we tried to figure out causes of fever and the prognosis of febrile patients in the ICU in a prospective, cohort method. Methods: From February to June 2007, patients admitted to medical ICU were daily screened and those who developed fever were enrolled. 237 consecutive admissions of 237 patients over a 5-month period were analyzed. Clinical parameters, including demographic data, underlying diseases, duration of ICU stay, causes of fever and final outcome were analyzed. Results: Fever (core temperature ≥38.3℃) was present in 8% of admission, and it was caused by infective (84.2%) and non-infective processes (15.8%). Most fever occurred within first 5 days in the course of the admission (68.4%) and most lasted less than 5 days (57.9%). The median Acute Physiology and Chronic Health Evaluation (APACHE) III score at the time of fever was 43 (±19). Those with infectious fever had no significant differences in terms of severity of diseases in comparison with those with non-infectious cause of fever. The most common cause of infective fever was pneumonia (n=11). Prolonged fever (≥5 days), all of which was caused by infection, occurred in 11 patients. Those with prolonged fever had higher mortality rate than short duration of fever (37.5% vs 0%, p<0.05). Conclusions: Infection, especially pneumonia is common cause of fever in the ICU. Prolonged fever is associated with high mortality rate.

중환자실 발열 환자에서 감염성과 비감염성 원인의 감별을 위한 혈청 Procalcitonin의 측정

김호철 ( Ho Cheol Kim ),김광민 ( Kwang Min Kim ),이상민 ( Sang Min Lee ),이승준 ( Seung Jun Lee ),함현석 ( Hyun Seok Ham ),조유지 ( Yu Ji Cho ),정이영 ( Yi Yeong Jeong ),이종덕 ( Jong Deok Lee ),황영실 ( Young Sil Hwang ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1

배경: 중환자실에서 발열은 가장 흔한 임상 상황이며 그 원인을 감염성 또는 비감염성으로 감별하는 것은 적절한 치료와 예후 측면에서 매우 중요하다. Procalcitonin(PCT)는 최근 여러 감염 질환의 뛰어난 표식자로 보고되고 있다. 연구자 등은 중환자실 발열 환자에서 혈청 PCT의 측정이 감염성과 비감염성 원인을 감별하는 데 도움이 되는지 알아보기 위해 연구를 시행하였다. 방법: 2005년 3월부터 8월까지 내과 중환자실에서 치료받은 환자 중 38˚C 이상의 발열이 있는 환자를 대상으로 백혈구, CRP, PCT, IL-6, TNF-α를 측정하였고 원인을 규명하기 위한 검사를 시행하였다. 감염성과 비감염성 원인의 감별은 배양 검사 결과와 임상적인 경과에 의존해 판단하였다. 감염성 발열 환자, 비감염성 발열 환자, 발열이 없는 중환자 및 건강 성인에서 각각의 값을 비교하였다. 결과: 1) 총 42명의 환자를 대상으로 46예의 발열에 대해 평가하였다. 감염성으로 생각된 경우는 26예, 비감염성은 13예, 7예는 원인이 명확하지 않았다. 2) 감염성과 비감염성 원인의 발열의 정도, 백혈구 수, CRP, IL-6, TNF-α는 유의한 차이가 없었다. 3) 감염성 원인과 비감염성 원인의 혈청 PCT는 각각 15.1±32.57ng/㎖, 2.68±3.63ng/㎖로 감염성 원인이 높았으나 통계적인 유의성은 없었다(p=0.06). 4) 발열이 있는 환자의 혈청 PCT은 10.94±27.15ng/㎖로, 발열이 없는 중환자의 0.45±0.49ng/㎖에 비해 의미 있게 높았다(p=0.02). 결론: 중환자실 발열 환자에서 혈청 PCT의 측정은 감염성 원인과 비감염성 원인을 감별하는 데 도움이 되지 않을 것으로 사료된다. Background: Although fever is one of the most common and challenging problem in intensive care medicine(ICU), it is difficult to distinguish between infectious and non-infectious causes. Procalcitonin(PCT) has recently been reported to be an indicator of various infectious diseases. This study examined whether or not measuring the serum PCT level in patients with fever in the ICU can help distinguish fevers with infectious causes from those with non-infectious causes. Methods: ICU patients with fever at 38℃ or over from March to August 2005 were prospectively enrolled. The cause of the fever was identified by the culture results and clinical course. The leukocytes, CRP, PCT, IL-6, and TNF-α in the fever patients with infectious and non-infectious causes were compared, and the PCT level in the patients with fever in the ICU were compared with those without fever. Results: 1) 42 patients were enrolled and 46 cases of fever were analyzed. 26 cases were considered to be infectious, while 13 cases were considered to be non-infectious. 7 cases were found to have no clear causes. 2) There were no significant differences in the degree of fever, leukocytes count, CRP, IL-6, and TNF-α levels in the patiemts with infectious and non-infectious causes. 3) The serum PCT level was higher in those with infectious causes than in those with non-infectious causes (15.1±32.57ng/㎖ vs 2 .68±3.63ng/㎖) but there was no statistical significance (p=0.06). 4) The serum PCT level of the ICU patients with fever was significantly higher than in those without fever (10.94±27.15ng/㎖ vs 0.45±0.49ng/㎖) (p=0.02). Conclusion: The serum PCT cannot be used to distinguish the fever in ICU patients with infectious causes from that with non-infectious causes. (Tuberc Respir Dis 2006; 61: 20-25)

1980년대 중국 문화열의 재발견과 현장 ― 80년대 회고를 중심으로

양태근 한국중국현대문학학회 2007 中國現代文學 Vol.0 No.43

This paper basically focuses on the “Culture Fever” of the 1980s in the main land China. Recently in China “Culture Fever” related research and review began emerging. This new rapid upsurge trend, in this paper temporarily named it as a “Recalling Fever”. This paper's main focus is How better understanding of China's “Culture Fever” and the current “Recalling Fever”. Culture Fever was not only critical reflect and review on the “Cultural Revolution”, but also was a new era of opportunity for china's cultural innovation. However, after the June 4, 1989, Tiananmen Square incident, the political direction of cultural movement, come to an end, and the Communist authorities to the reform and opening up policy and rapid economic growth finally stifle the vitality of the “Culture Fever”. This unfinished task of the “Culture Fever”, requirements of cultural innovation, for now through “Recalling Fever” reflect reality, a kind of despair and introspection about the China's economic reforms and opening up with the economy accomplishment but without fair social environment, cultural creativity and political hope. Although this “Recalling Fever” is apparently good research point to understand “Culture Fever”. But from the perspective of sociology of knowledge, in this “Recalling Fever” we still can be found some competition between most important cultural knowledge groups. They have not only participated in the “Recalling Fever”, but also make the new frame the ongoing review of “Culture Fever”. Who has the power of the interpretation about the “Culture Fever” may another core issue on this “Recalling Fever”.

Postoperative Fever Evaluation Following Lumbar Fusion Procedures

Benjamin C. Mayo,Brittany E. Haws,Daniel D. Bohl,Philip K. Louie,Fady Y. Hijji,Ankur S. Narain,Dustin H. Massel,Benjamin Khechen,Kern Singh 대한척추신경외과학회 2018 Neurospine Vol.15 No.2

Objective: This study aimed to determine the incidence of postoperative fever, the workup conducted for postoperative fever, the rate of subsequent fever-related diagnoses or complications, and the risk factors associated with fever following lumbar fusion. Methods: A retrospective review of patients undergoing lumbar fusion was performed. For patients in whom fever (≥38.6°C) was documented, charts were reviewed for any fever workup or diagnosis. Multivariate regression was used to identify independent risk factors for the development of postoperative fever. Results: A total of 868 patients met the inclusion criteria, of whom 105 exhibited at least 1 episode of fever during hospitalization. The first documentation of fever occurred during the first 24 hours in 43.8% of cases, during postoperative hours 24–48 in 53.3%, and later than 48 hours postoperatively in 2.9%. At least 1 component of a fever workup was conducted in 47 of the 105 patients who had fever, resulting in fever-associated diagnoses in 4 patients prior to discharge. Three patients who had fever during the inpatient stay developed complications after discharge. On multivariate analysis, operations longer than 150 minutes (relative risk [RR], 1.66; p=0.015) and narcotic consumption greater than 85 oral morphine equivalents on postoperative day 0 (RR, 1.53; p=0.038) were independently associated with an increased risk of developing postoperative fever. Conclusion: The results of this study suggest that inpatient fever occurred in roughly 1 in 8 patients following lumbar fusion surgery. In most cases where a fever workup was performed, no cause of fever was detected. Longer operative time and increased early postoperative narcotic use may increase the risk of developing postoperative fever.

악성고형종양 환자에 있어서 Neoplastic Fever 와 Infectious Fever 의 감별을 위한 Naproxen 의 투여

송시영(Si Young Song),김준명(June Myeong Kim),김주항(Joo Hang Kim),김웅(Eung Kim),홍천수(Chein Soo Hong) 대한내과학회 1989 대한내과학회지 Vol.37 No.4

N/A Recurrent unexplained fever as a manifestion of certain malignancies is a well described phenomenon and is usually attributed to infection related to the immunocompromised state, from either the cancer itself or chemotherapy. However, fever might originate from the tumor per se, namely neoplastic fever, and the differential diagnosis of the infectious fever and the neoplastic fever becnmes a true challenge to the clinician due to its urgency and necessity for appropriate treatment. Thus, we evaluated the antipyretic effect of naproxen in 18 febrile patients who were diagnosed with a malignant solid tumor for the purpose of differentiation of the neoplastic fever and the infectious fever. All 10 patients with neoplastic fever showed complete lysis and an afebrile stafe was sustained while the patients were maintained on naproxen. Among 8 patients with infectious fever, 4 patients showed no lysis, 3 patients partial response, and 1 patient complete lysis. Even though the naproxen dosage was increased to a dose of 250 mg every 6 or H hours in the patients who showed no response, partial response was noticed only in two patients and the remaining two patients continued to show no response. Naproxen is well known to cause gastrointestinal side effects and functional platelet defects. However, in our experience, the side effects have been minimal because most of the patients have received a relatively short course of therapy. In conclusion, naproxen appears to be a very effective tool in assisting in the differential diagnosis of infectious fever and neoplastic fever in patients with a malignant solid tumor.

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

( In Hee Lee ),( Sung Ae Koh ),( Soo Jung Lee ),( Sun Ah Lee ),( Yoon Young Cho ),( Ji Yeon Lee ),( Jin Young Kim ) 영남대학교 의과대학 2021 Yeungnam University Journal of Medicine Vol.38 No.4

Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic. Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records. Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%). Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.

교육열 개념의 유형화 및 비판적 검토: 은유와 교육을 중심으로

신기현 한국교육원리학회 2009 교육원리연구 Vol.14 No.1

이 논문은 교육열의 개념화에 작용한 열에 대한 은유적 사고와 교육개념을 중심으로 기존 교육열 연구들에서 제시된 교육열의 개념을 유형화하여 검토하고, 교육열 개념화의 진전을 위해 고려해야 할 사항을 제안하고 있다. 이를 위해 먼저 교육열의 개념을 에너지, 열병, 동기, 열정의 은유를 중심으로 네 가지 유형으로 제시하였다. 그리고 각 유형에 속하는 대표적인 연구를 사례로 하여 각 은유를 중심으로 어떻게 교육열이 개념화되고 있고, 그것을 토대로 어떤 연구문제들이 제시되고 있는지를 살펴보았다. 다음으로는 교육열의 개념화 과정에서 각 연구자들이 열과 교육에 대해 어떤 개념을 제시하고 있고, 또 어떻게 다루고 있는지를 검토하였다. 마지막으로 교육열의 연구가 발전하기 위해 고려해야 할 사항으로 교육개념의 정립, 올바른 용어사용, 내재변인으로서의 교육열 연구를 제안하였다. This paper aimed to critically review the concept of education fever and suggest research issues of education fever. I reviewed the conceptualization of education fever with focusing on metaphor and education that concept and research questions of education fever were based on. The metaphors had played an important role to formulate a concept and research questions in the study of education fever. There were four types of metaphors that had been used by researchers: metaphor of heat, fever, motive, and passion. This paper examined the way that the education fever was conceptualized and research questions were constructed by each metaphor. The concept of education is a critical element of concept of education fever, and therefore the study of concept of education should be important part of research of education fever. But an inquiry into the concept of education was disregarded by researchers. Some researchers differentiated the concept of education from schooling, and the concept of eduction for the study of education fever was restricted to schooling. But they did not inquire further about what is schooling, and how different schooling is from education. It was recommended that a new approach to the study of education fever be required. First, an inquiry into the concept of education is regarded as important issues of the study of eduction fever. Second, the terminology of the research is chosen and used more strictly. Lastly, new research which the education fever is regarded as endogenous variable of education is required.

유학, 죄인인가? 구원자인가? -교육열(敎育熱)과 공부열(工夫熱)-

이우진 ( Woo Jin Lee ) 한국교육사학회 2013 한국교육사학 Vol.35 No.2

한국에서 유학은 자생적 근대화를 이루지 못하여 피식민 지배를 받게 한 죄인이자, 놀라운 경제성장을 꽃피우게 한 구원자이기도 하다. 이 글이 다루고 있는 주 대상인 ‘교육열’도 한국의 급속한 경제발전을 이루게 한 ‘유학의 산물’ 이기도 하지만, 현재 한국 교육의 심각한 병리적 현상의 주범으로 이해되기도 한다. 하지만 이 글은 현대의 교육열은 유학의 산물이 아니며, 유학의 교육열과는 다른 차원의 개념으로 파악한다. 교육열은 근대적 입장과 해석에서 기원한 것이지 결코 유학 전통의 연장선에서 이해될 수 없다고 생각한다. 조선유학의 교육열을 사실 ‘공부열’이라 칭할 수 있을 것이다. 조선의 유학 교육은 현대 교육과 같이 ‘나아감’으로만 치우치지 않았다. 나아감의 철학보다 물러남의 철학을 더 중요한 교육적 의미를 지니고 있다고 생각했다. 한국의 교육열은 ‘사회진화론’과 ‘지식은 권력’이라는 근대적 지식에 대한 인식체계의 확산을 그 기원으로 삼는다. ‘교육’은 ‘사회진화와 개화’를 위한 가장 중요한 지점이자, ‘도태되지 않고 적자(適者)가 되어 생존경쟁에서 살아남기 위한 수단’으로 자리매김하게 되었다. 교육을 개인상승을 위한 도구적 수단으로서 이해 하는 방식은 해방이후 산업화를 거쳐 더욱 노골화되고, 신자유주의 이념은 이를 더욱 강화된다. 여기에 ‘나아감’의 철학을 우선시하는 뜨거운 교육열을 유학의 전통인 ‘공부열’로 냉각시켜야 할지도 모른다. 그것이 진정 이루어진다면 유학은 다시 우리에게 구원자로 되살아나게 될 것이다. The Confucianism is not only the sinner but the savior. It is the former as the causes of not modernizing Korea autochthonously and the Japanese colonial rule. And, it is the latter as the cause of remarkable economic growth. The subject of ‘Education Fever(敎育熱)’ is understood as the ambivalent concept. It had been understood as ‘the confucian product’ led the Korea`s rapid economic development, and the major contributor to serious pathological phenomena in education as well. However, this article grasps that ‘Education Fever’ is not the confucian product and that it is the other dimension concept of ‘the Confucian Education Fever.’ The ‘Education Fever’ is originated in the modern perspective and interpretation, so, it cannot be understood as the continuation of confucian tradition. ‘The Confucian Education Fever in Joseon dynasty’ may be called as ‘Cultivation Passion(工夫熱).’ Unlike the current education in Korea, the confucian education in Joseon dynasty was not one-sided with ‘Advancing.’ That regarded ‘Withdrawing’ as more important than ‘Advancing.’ ‘Education Fever in Korea’ is orginated in the spreading of modern awareness that ‘Social Darwinism’ and ‘Knowledge is power.’ Education was the most important point of ‘the evolution and civilization of society’ at that time. The way of understanding education as the personal elevation tool had been generalized during the industrialization period after the liberation from Japanese colonial rule. And Neo-liberalism has been strengthened the thinking way. It is time to cool the hot ‘Education Fever’ with ‘Cultivation Passion.’ The Confucianism is not only the sinner but the savior. It is the former as the causes of not modernizing Korea autochthonously and the Japanese colonial rule. And, it is the latter as the cause of remarkable economic growth. The subject of ‘Education Fever(敎育熱)’ is understood as the ambivalent concept. It had been understood as ‘the confucian product’ led the Korea`s rapid economic development, and the major contributor to serious pathological phenomena in education as well. However, this article grasps that ‘Education Fever’ is not the confucian product and that it is the other dimension concept of ‘the Confucian Education Fever.’ The ‘Education Fever’ is originated in the modern perspective and interpretation, so, it cannot be understood as the continuation of confucian tradition. ‘The Confucian Education Fever in Joseon dynasty’ may be called as ‘Cultivation Passion(工夫熱).’ Unlike the current education in Korea, the confucian education in Joseon dynasty was not one-sided with ‘Advancing.’ That regarded ‘Withdrawing’ as more important than ‘Advancing.’ ‘Education Fever in Korea’ is orginated in the spreading of modern awareness that ‘Social Darwinism’ and ‘Knowledge is power.’ Education was the most important point of ‘the evolution and civilization of society’ at that time. The way of understanding education as the personal elevation tool had been generalized during the industrialization period after the liberation from Japanese colonial rule. And Neo-liberalism has been strengthened the thinking way. It is time to cool the hot ‘Education Fever’ with ‘Cultivation Passion.’

부모의 교육열 유형에 따른 아동의 자아 존중감, 행복감, 학업수행능력, 교사-아동관계의 차이에 관한 분석

정연아(Jung Youn Ah),유준호(Ryu Jun Ho) 학습자중심교과교육학회 2019 학습자중심교과교육연구 Vol.19 No.20

The purpose of this study examines the differences of students’ self-esteem, school achievement and teacher-child relationships depending on the parents’ types of education fever. The study considers the education fevers of both father and mother using data of 584 nine-year-old students in second grade Panel Study on Korea Children(PKSC). The major results of this study are as follows: First, results of cluster analysis show that there were four types of education fever for parents: father and mother with high education fever, only mother with high education fever, father and mother with low education fever, and only father with higher education fever. Next, among parents’ education fever types, the Group 1(father and mother with high education fever) and the group 2(only mother with high education fever) are likely to include fathers and mothers with higher education levels. However, there were no statistically differences among types of education fever according to parent’s income levels. demonstrated the group parents’ education level. Thirdly, types of education fever for parents have no statistically significant differences depending on parents’ stress in life and satisfaction for life. Fourth, students’ self-esteem, happiness, school achievement demonstrated statistically among the types of education fever. Yet, there were no differences of student-teacher relationships among the types of parents’ education fever. 본 연구의 목적은 부모의 교육열 유형에 따른 부모의 특성을 알아보고, 부모의 교육열 유형에 따라 아동의 자아 존중감, 행복감, 학업수행능력 및 교사-아동 관계에 차이가 있는 알아보기 위한 것이다. 한국아동패널 9차년도(2016년도) 584명의 자료 (초등학교 2학년)를 기초로 어머니와 아버지의 교육열을 동시에 고려한 군집분석을 실시하였다. 본 연구에서 도출된 주요 분석결과는 다음과 같다. 첫째, 네 가지 유형의 부모 교육열-아버지 어머니 교육열이 모두 높은 집단, 어머니 교육열이 높은 집 단, 아버지 어머니 모두 교육열이 낮은 집단, 그리고 아버지 교육열이 높은 유형-으로 구분되었다. 둘째, 학력이 높을수록 교육열이 높게 나타났으며, 소득에 따라서는 집단간의 유의미한 차이를 보이지 않았다. 셋째, 부모의 일상적 스트레스와 삶의 만 족도는 부모 교육열 유형에 따라 통계적으로 유의한 차이를 보이지 않았다. 넷째, 아동의 자아존중감, 행복감, 학업수행능력은 부모의 교육열 유형에 따라 유의한 차이가 있는 것으로 나타났다. 한편 부모의 교육열 유형에 따라 아동-교사 관계에는 차 이가 없는 것으로 나타났다.

조중환의 번안소설과 열병의 상상력 -장티푸스의 변주와 형상화를 중심으로

박성호 한국현대소설학회 2024 현대소설연구 Vol.0 No.93

장티푸스는 20세기 중반까지 맹위를 떨쳤던 감염병으로 한국에서도 여러 차례유행한 바 있다. 이미 19세기 말부터 위생과 방역을 중심으로 한 대응이 이루어졌으며, 대중들에게도 주요한 감염병 가운데 하나로 폭넓게 인식되고 있었다. 하지만 문학 작품에서는 장티푸스가 직접적으로 등장하는 사례를 찾아보기 어렵다. 신경쇠약이 결핵, 천연두 등과 달리 장티푸스는 1910년대 초반까지도 거의소설에서 거론되지 않았다. 조중환의 번안소설인 「쌍옥루」나 「비봉담」에 이르러서야 비로소 등장하게 되는데, 이 역시 장티푸스를 병명을 직접적으로 채택하지는 않았다. 조중환의 번안소설에서 장티푸스는 감염병의 측면보다는 불명열(不明熱)의 일환으로 등장한다. 감염병임을 추론할 수 있는 서술이 작중에서 등장하기는 해도 발병의 중심에는 작중인물의 죄책감과 같은 심리적 요인이 강하게 작동한다. 이는19세기 영미소설이 채택한 neural fever와도 연결된 것으로, 열이라는 요소를 중심으로 작중의 갈등을 설명하거나 이를 해소하는 계기를 제시하였다. 다른 한편으로는 열병을 중심으로 하여 근대의료를 소설 속에 본격적으로 도입하는 계기를 마련하기도 했다. 혈액검사와 혈청주사, 체온 측정을 중심으로 한 진단과 치료는 모두 의사와 의료기관을 중심으로 이루어지며, 작중인물의 병을 치료하는 것 역시 의사의 역할로 분리된다. 같은 시기 소설에서 나타나는 신경쇠약이의료와는 무관하게 작중인물 간의 갈등 해소를 통해 치유된다는 점을 감안하면, 장티푸스를 중심으로 한 열병의 상상력은 소설에서의 근대의료를 구체화하는 데 적잖은 역할을 수행하였다고 볼 수 있다. 나아가서는 열병을 중심으로 결핵이나 신경쇠약과 같은 여타의 질병과도 연결될 수 있는 지점을 마련한다는 점도 주목할 필요가 있다. 이는 20세기 초 문학에서질병을 인식하고 형상화하는 양상을 살펴보는 데 또 다른 시각을 제공할 수 있을것이다. Typhoid fever was a rampant infectious disease until the mid-20th century, experiencing several outbreaks in Korea. Since the late 19th century, responses centered around hygiene and quarantine were implemented, and it was widely recognized as one of the major infectious diseases among the public. However, it is difficult to find cases where typhoid fever directly appears in literary works. Unlike neurasthenia, tuberculosis, or smallpox, typhoid fever was almost never mentioned in novels until the early 1910s. It was not until Jo Jung-hwan's adapted novels, such as "Ssangokru" and "Bibongdam," that typhoid fever finally made an appearance, albeit not adopting the disease name directly. In Jo Jung-hwan's adapted novels, typhoid fever appears more as a part of an unknown fever than from the aspect of an infectious disease. Although there are descriptions that allow readers to infer it as an infectious disease, psychological factors like the characters' guilt play a strong role at the outbreak's center. This is connected to the neural fever adopted in 19th-century English and American novels, where fever is central to explaining conflicts within the story or providing an opportunity for resolution. On the other hand, these novels also provided an opportunity to formally introduce modern medicine into the story, centered around fever. Diagnosis and treatment focused on blood tests, serum injections, and temperature measurements are all conducted by doctors and medical institutions, separating the act of curing the characters' diseases as the doctors' role. Considering that neurasthenia, appearing in novels from the same period, is healed through the resolution of conflicts between characters independently of medical intervention, the imagination of fever centered around typhoid fever plays a significant role in concretizing modern medicine in literature. Furthermore, it is worth noting that fever, centered around typhoid, creates connections with other diseases such as tuberculosis and neurasthenia. This offers another perspective in examining how diseases were recognized and visualized in early 20th-century literature.