恙虫病误诊56例临床分析  

Analysis of the clinical data from 56 misdiagnosis patients with Tsutsugamushi

作　　者：张文弢[1] 朱坤[1] 张海燕[1] 李晓红[1] 张瑞侠[1] 

机构地区：[1]淮南朝阳医院呼吸内科,安徽省淮南232007

出　　处：《中国基层医药》2015年第8期1157-1159,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：提高对恙虫病流行病学、临床特点和诊治的认识，降低误诊率。方法对56例恙虫病误诊患者的临床资料进行回顾性分析。结果误诊为急性上呼吸道感染28例（50．0％）、疟疾3例（5．4％）、胆囊炎1例（1．8％）、感染性发热24例（42．8％）。平均误诊时间10．3 d。55例患者发现焦痂或溃疡（98.2％），54例为1个部位发现焦痂或溃疡，1例发现2个焦痂。54例治疗有效，50例使用氯霉素治疗，4例使用阿奇霉素治疗，体温降至正常平均时间分别为1．3 d、1 d。结论提高对恙虫病认识，认真询问病史及识别特异性体征，能够降低误诊率，从而降低病死率。Objective To improve the understanding of the epidemiology,clinical features,diagnosis and treatment of Tsutsugamushi disease,and reduce the misdiagnosis rate.Methods The clinical data of 56 cases of Tsutsugamushi disease misdiagnosed were analyzed retrospectively.Results 28 cases were misdiagnosed as acute upper respiratory tract infection（50.0%）,3 cases were malaria（5.4%）,1 case was cholecystitis（1.8%）,24 cases were infectious fever（42.8%）.The average misdiagnosed time：10.3days.55 patients were found Eschar or ulcer （98.2%）,54 cases were found Eschar or ulcer on one part of body,1 case was found two eschars.54 cases had been effectively treated,50 cases were treated with chloramphenicol,4 cases with azithromycin.The average time of temper-ature that dropped to normal were respectively：1.3d,1d.Conclusion awareness of Tsutsugamushi disease should be raised,history seriously should be inquired and specific signs should be identified,which can degrade the misdiagnosis rate and reduce the mortality rate.

关 键 词：恙虫病 误诊 

分 类 号：R513.2[医药卫生—内科学]