恙虫病在我国主要分布于东南和西南地区,长江以北比较少见。对北方地区的散发病例,早期极易误诊或漏诊。现将我院首次门诊或入院初诊时误诊14例作一简要分析,以从中吸取教训。最后诊断依据:①病人有野外作业史;②突然高热,并特异性焦痂或溃疡;③淋巴结肿大、肝大、皮疹;④变形杆菌OXk凝集试验阳性(凝集效价大于1:80);⑤四环素治疗有特效。在误诊的14例中,男性6例,女性8例;年龄最大57岁,最小12岁。误诊时间6～18天,平均11天。误诊的疾病:误诊为流行性出血热5例,伤寒2 Tsutsugamushi disease in our country mainly in the southeast and southwest, north of the Yangtze River is relatively rare. Sporadic cases of the northern region, early misdiagnosis or missed diagnosis. Now our hospital for the first time outpatient or admission misdiagnosis 14 cases for a brief analysis to learn from. The final diagnosis is based on: ① the patient has a history of field operations; ② sudden high fever and specific eschar or ulcer; ③ lymph nodes, liver, rash; ④ Proteus OXk agglutination test was positive (agglutination titer greater than 1:80); ⑤ tetracycline treatment effects. In misdiagnosed 14 cases, 6 males and 8 females; the oldest 57 years old, the youngest 12 years old. Misdiagnosis time 6 to 18 days, an average of 11 days. Misdiagnosis of the disease: misdiagnosed as epidemic hemorrhagic fever in 5 cases, typhoid 2