恙虫病诊治进展附恙虫病致多器官功能损伤1例报告  

Progress in diagnosis and treatment of tsutsugamushi disease——a case report of tsutsugamushi disease with multiple organ dysfunction

作　　者：黄楷壮 冉莹琪 黎宁君 杜大昊 程滔 李蓉 娄邵菲 Huang Kaizhuang;Ran Yingqi;Li Ningjun;Du Dahao;Cheng Tao;Li Rong;Lou Shaofei(Department of Intensive Care Unit,The Fifth Affiliated Hospital of Sun Yat-sen University,Guangdong Zhuhai 519000,China;Department of Emergency,The Fifth Affiliated Hospital of Sun Yat-sen University,Guangdong Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院重症医学科,广东珠海519000 [2]中山大学附属第五医院急诊医学科,广东珠海519000

出　　处：《新发传染病电子杂志》2022年第2期99-103,共5页Electronic Journal of Emerging Infectious Diseases

摘　　要：恙虫病是由恙虫病东方体引起的一种急性自然疫源性传染病,其临床表现多样且无特异性,易漏诊及误诊。本文对恙虫病防治的最新进展进行综述,并附1例恙虫病感染致多器官功能损伤、经治疗后好转的病例,旨在提高恙虫病特别是重症恙虫病的临床诊疗水平。流行病学上,我国恙虫病在时间上分为夏季型和秋季型,全国各地均有报道且发病数逐年上升,各个年龄段均有发生病例且主要为户外工作者。临床表现为高热、皮疹、焦痂、多器官功能损害等。传统诊断方法存在阳性率低、特异性差等特点,随着科研进展,目前有二代基因测序等最新诊断技术。治疗上多采用一般治疗、病因治疗以及对症支持治疗,四环素类药物是有效的抗生素,当出现多器官功能损伤时,呼吸机辅助呼吸、血液净化、人工肝等支持技术能提高疗效。Tsutsugamushi disease is an acute natural infectious disease caused by Orientia tsutsugamushi.The clinical manifestations are diverse and non-specific,resulting in easy to miss diagnosis and misdiagnosis.In this paper,the progress in the research of tsutsugamushi disease was reviewed,and a case of tsutsugamushi disease with multiple organ dysfunction was reported,aiming to improve the clinical diagnosis and treatment level of tsutsugamushi disease,especially severe cases.In terms of epidemiology,tsutsugamushi disease in China can be divided into summer type and autumn type.The cases have been reported all over the country and the incidence is increasing year by year.Cases have occurred in all ages and are mainly outdoor workers.Clinical manifestations include high fever,rash,eschar and multiple organ dysfunction.The traditional diagnostic methods are characterized by low positive rate and poor specificity.With the development of scientific research,the latest diagnostic techniques such as second-generation gene sequencing have been developed.In terms of treatment,general treatment,etiological treatment and supportive treatment are mostly adopted.Tetracycline drugs are effective antibiotics.When multiple organ function injury occurs,support technologies such as mechanical ventilation,blood purification and artificial liver can improve the efficacy.

关 键 词：恙虫病 焦痂 多器官功能障碍 二代基因测序 

分 类 号：R513.2[医药卫生—内科学]