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目的分析恙虫病的临床表现、并发症、治疗效果及误诊原因。方法对37例恙虫病进行回顾性分析。结果本组病例发热37例(100%)浅表淋巴结肿大15例(40.6%),有焦痂或溃疡或皮疹者30例(81.2%),肝肿大4例(10.9%)脾肿大2例(5.4%),肝功能异常者25例(67.6%),变形杆菌OXk凝集反应阳性13例(35.2%),误诊率为21%。结论提高对发热,浅表淋巴结肿大,多器官功能障碍病人的警惕性,详细体格检查,及早发现焦痂,是避免误诊的关键。
Objective To analyze the clinical manifestations, complications, therapeutic effects and misdiagnosis of scrub typhus. Methods 37 cases of tsutsugamushi disease were retrospectively analyzed. Results In this group, 37 cases (100%) had superficial lymph node enlargement in 15 cases (40.6%), 30 cases (81.2%) had eschar or ulcer or rash, 4 cases (10.9%) had enlarged hepatomegaly There were 2 cases (5.4%), 25 cases (67.6%) with abnormal hepatic function, 13 (35.2%) positive for Proteus OXk agglutination, and the misdiagnosis rate was 21%. Conclusion To improve the vigilance of patients with fever, superficial lymph nodes and multiple organ dysfunction, detailed physical examination and early detection of eschar are the key points to avoid misdiagnosis.