恙虫病是由恙虫病立克次体以恙螨幼虫为媒介所引起的一种急性自然疫源性传染病。山东省沂蒙山区于1985～1987年发生大规模暴发流行,均为典型病例,但近几年来所见病例大多不典型,易误、漏诊。本文总结不典型患者30例,结合临床体会就诊断问题作一探讨。 Scrub typhus is from Rickettsia tsutsugamushi Rickettsia chigger mite larvae as a medium caused by an acute natural foci of infectious diseases. Large-scale outbreaks occurred in Yimeng Mountainous Area of ​​Shandong Province from 1985 to 1987, all of which are typical cases. However, most of the cases seen in recent years are not typical, easily misdiagnosed and missed. This article summarizes 30 cases of atypical patients, combined with clinical experience on the diagnosis of a discussion.