恙虫病24例临床分析  

Clinical Features of 24 Patients with Scrub Typhus

作　　者：孙彩虹[1] 杜素萍[1] 张彩萍[1] 张宇[1] 

机构地区：[1]江苏大学附属人民医院皮肤科,江苏镇江212002

出　　处：《中国皮肤性病学杂志》2016年第9期915-917,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的了解恙虫病的临床和实验室特征。方法回顾性分析2015年在江苏大学附属人民医院住院治疗的24例恙虫病患者的一般特征、临床表现、实验室检查和治疗情况。结果 24例恙虫病患者在2015年11月初至12月底集中发病,以发热(100%,24/24)、焦痂或溃疡(87.50%,21/24)、斑丘疹(70.83%,17/24)及外周淋巴结肿大(50.00%,12/24)为主要表现。血液指标:血细胞下降(25.00%,6/24)、血小板减少(25.00%,6/24)、C反应蛋白升高(91.67%,22/24)、腺苷脱氨酶(ADA)升高(91.67%,22/24)。胸部影像学异常(16.67%,4/24)。以米诺环素、多西环素或阿奇霉素治疗为主,23例痊愈,1例合并EB病毒感染中毒性脑炎。结论 2015年11月初至12月底恙虫病属历史上镇江地区首次集中发病,临床表现典型,诊断明确,部分患者病情较重。临床医生需在工作中加以识别和尽早诊治。Objective To study the clinical and laboratory features of 24 cases with scrub typhus. Methods We retrospectively analyzed the general information, clinical manifestations, laboratory and image examination, and treatment of 24 inpatients with scrub typhus at the affiliated people＇ s hospital of Jiangsu University from January to December 2015. Results The main clinical manifestations included high fever（ 100% , 24/24） ,eschar or ulcer （ 87.50% , 21/24 ） , rash （ 70. 83% , 17/24 ） , lymphadenopathy （ 50. 00% , 12/24 ） and other non-specific symptoms. Other abnormalities included reduction in blood cell count（25.00% , 6/24） ,thromboeytopenia （ 25.00% , 6/24） , elevated C reactive protein （CRP） （91.67% , 22/24） and increased adenosine deaminase （ADA） （91.67% , 22/24）. 16. 67% （4/24） of patients showed chest X ray abnorulalities. All the patients recovered after treatment with moxifloxacin, doxycycline, or azithromycin, except one with complications of EB virus infection and toxic encephalitis. Conclusion It was the first time that scrub typhus occurred convergently in Zhenjiang area between November and December 2015. Most patients with scrub typhus have typical clinical manifestations. Some of them were severe. Clinicians should recognize this disease in order to make an early diagnosis and to give proper treatments.

关 键 词：恙虫病 

分 类 号：R757[医药卫生—皮肤病学与性病学]