Since 1986, when tsutsugamushi disease was first reported in Korea, there have been numerous reports about the disease and the prevalent season was from late fall to early winter. In Japan, there have been reports of its occurrence in the spring, so it is possible that it may also occur in the spring in Korea. We experienced a case of tsutsugamushi disease which occurred in May of 1988. The patient was a 72-year-old female living in Kyungki-Do who visited Severance Hospital because of fever, abdominal pain and vomiting of 12 days duration. The diagnosis was confirmed as tsutsugamushi disease by clinical findings such as eschar and high antibody titers on indirect immunoperoxidase assay. She showed clinical features of adult respiratory distress syndrome and disseminated intravascular coagulopathy, but completely recovered with chloramphenicol and other supportive management.