珠海地区恙虫病70例临床分析

目的:探讨珠海地区恙虫病的临床特点,减少误诊、漏诊。方法:对某医院2011~2012年期间就诊的70例恙虫病患者的临床资料进行回顾性分析。结果:珠海地区恙虫病流行季节为4月~12月。有明确野外接触史42例,占60%;有发热症状63例,占90%;有焦痂59例,占84%;溃疡4例,占6%;有皮疹15例,占21%。血常规检测中,白细胞参考范围值正常44例,占62%,其余升高和降低各13例,各占19%。外斐氏试验—恙虫病抗体阳性(1:160以上)4例,阳性率为8%。70例经四环素或氯霉素抗立克次体病原体治疗后,治愈率达100%。结论:患者大都具有明确的野外接触史,以发热、焦痂、溃疡、淋巴结肿大为主要临床表现;外斐氏试验阳性率低且不具有特异性;四环素、氯霉素抗病原体治疗效果好。

Clinical analysis of 70 tsutsugamushi disease patients in Zhuhai city

Objective：To investigate the clinical characteristics of 70 tsutsugamushi disease patients in Zhuhai city, decreasing misdiagnose and missed diagnosis.Methods：A retrospective analyses on the clinical information of 70 tsutsugamushi disease patients who was diagnosed in our infirmary. Results：The peak time of tsutsugamushi disease in Zhuhai city was from Apr to Dec. Among the 70 tsutsugamushi disease patients there were 42 cases of contacting with grass and brushwood （60%）, 63 cases of fever （90%）, 59 cases of eschar（84%）, 4 cases of ulcer（6%） and 15 cases of skin rash 21%. Weil-Felix test showed 4 cases were positive antibody of tsutsugamushi （8%）. The 70 tsutsugamushi disease patients were cured by antiviral therapy with tetracycline and chloramphenicol, and the cure rate was 100%. Conclusion： Most of the tsutsugamushi disease patients had obvious history of contact with open air.the chief clinical manifestations were fever, eschar, ulcer, lymph node tumescent. Antiviral therapy with tetracycline and chloram- phenicol was good for tsutsugamushi disease.