厦门市恙虫病例流行病学资料与临床表现

目的分析厦门市近年恙虫病患者流行病学资料和临床表现,提高确诊率。方法回顾性分析46例恙虫病住院患者的病历资料。结果患者多为成年人（91.3%）,多有野外活动史（84.8%）,发病季节2~11月。35例（76.1%）出现多脏器损伤,少数合并脑膜炎、胰腺炎及格-巴二氏综合征（GBS）等并发症;合并肾综合征出血热（HFRS）1例。OXk≥1∶160仅12例（27.9%）。入院当天确诊25例（54.3%）。结论恙虫病多发生于有野外活动史者;临床表现复杂,易误诊。详细询问流行病史、全面查体、完善检验是减少误诊关键。

Epidemiologial and clinical manifestations of tsutsugamushi cases in Xiamen City

Objective To analyze the epidemiological and clinical features of tsutsugamushi cases for increasing the rate of correct diagnosis. Methods Clinical data of 46 hospitalized tsutsugamushi cases were analyzed retrospectively. Results Most cases were adult（91.3%）and shown the history of outdoor activities（84.8%）. All cases occurred from Feb. to Nov. 35 cases （76.1 %） presented multiple organ damages. Seldom cases presented meningitis, pancreatitis and Guil- lain-Barr Syndrome （GBS）. One case was diagnosed hemorrhagic fever with renal syndrome （HFRS）. 12 cases （27.9 % ） performed OXk ≥1 ： 160 only.25 cases 54.3% were diagnosed tsutsugamushi disease on the day of admission. Conclusion Most tsutsugamushi cases show history of outdoor activities. Clinical manifestations of tsutsugamushi ca- ses are complex and likely to be misdiagnosed. Taking disease history, physical examination and laboratory tests care- fully are the key measures to reduce the disease misdiagnosis.