30例恙虫病特殊临床表现分析及预防建议  

The special clinical manifestations of 30 cases of tsutsugamushi disease and its prevention suggestion

作　　者：王雪莲[1] 郭志南[2] 李峰[1] 傅建国[1] 陈潇潇[1] 牛建军[1] 

机构地区：[1]厦门大学附属中山医院,福建厦门361004 [2]厦门市疾病预防控制中心,福建厦门361021

出　　处：《中华卫生杀虫药械》2014年第5期478-481,共4页Chinese Journal of Hygienic Insecticides and Equipments

基　　金：福建省科技项目自然科学基金面上项目(编号:2013D008);厦门市卫生局医学科研项目联合资助(编号:WSK2010-01);厦门市科技计划项目(编号:3502Z20144062)

摘　　要：目的分析恙虫病典型与特殊临床表现,为准确诊断提供依据。方法回顾性分析30例确诊恙虫病住院患者的临床资料。结果 30例患者除发热、特异性溃疡或焦痂、淋巴结肿大、肝损害等典型表现外,特殊表现包括肺炎16例(53.3%)、心肌炎10例(33.3%)、肾损害9例(30.0%)、脑膜炎2例(6.7%)、胰腺炎1例(3.3%);确诊恙虫病合并流行性出血热感染1例。结论恙虫病临床表现复杂,易误诊。详细询问流行病学史、全面查体、完善检验是减少误诊关键。采取灭鼠、灭恙螨和个体防护等综合防治措施。Objective To analyze the typical and special features of tsutsugamushi disease for correct diagnosis. Methods Clinical data of 30 hospitalized tsutsugamushi disease patients were analyzed respectively. Results Be- sides fever, specific ulcer or eschar, swollen lymph node and liver injury, special clinical manifestations included pneu- monia（53.3% ） ,myocarditis （ 33.3% ） , kidney injury （ 30. 0% ） , meningitis （ 6. 7% ） , pancreatitis （ 3.3% ）. One patient was diagnosed with tsutsugamushi and epidemic hemorrhagic fever. Conclusion Clinical manifestations of tsutsugamushi disease are diverse. It is likely to be misdiagnosed. Detailed asking of history, physical examination and thorough laboratory tests are the key to reduce misdiagnosis. The enforcement of rodents control, chigger control and human protection should be conducted to prevent tsutsugamushi disease.

关 键 词：恙虫病 特殊临床表现 立克次体感染 

分 类 号：R184.3[医药卫生—流行病学]