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目的了解恙虫病的临床和实验室特征。方法回顾性分析2015年在江苏大学附属人民医院住院治疗的24例恙虫病患者的一般特征、临床表现、实验室检查和治疗情况。结果 24例恙虫病患者在2015年11月初至12月底集中发病,以发热(100%,24/24)、焦痂或溃疡(87.50%,21/24)、斑丘疹(70.83%,17/24)及外周淋巴结肿大(50.00%,12/24)为主要表现。血液指标:血细胞下降(25.00%,6/24)、血小板减少(25.00%,6/24)、C反应蛋白升高(91.67%,22/24)、腺苷脱氨酶(ADA)升高(91.67%,22/24)。胸部影像学异常(16.67%,4/24)。以米诺环素、多西环素或阿奇霉素治疗为主,23例痊愈,1例合并EB病毒感染中毒性脑炎。结论 2015年11月初至12月底恙虫病属历史上镇江地区首次集中发病,临床表现典型,诊断明确,部分患者病情较重。临床医生需在工作中加以识别和尽早诊治。
Objective To understand the clinical and laboratory features of scrub typhus. Methods A retrospective analysis of the general characteristics, clinical manifestations, laboratory tests and treatment of 24 patients with scrub typhus admitted to the Affiliated Renmin Hospital of Jiangsu University in 2015 was performed. Results Twenty-four cases of tsutsugamushi were concentrated in the period from the beginning of November to the end of December 2015, with fever (100%, 24/24), eschar or ulcer (87.50%, 21/24), maculopapular rash (70.83%, 17/24 ) And peripheral lymph nodes (50.00%, 12/24) as the main performance. Hematological parameters: decreased blood cells (25.00%, 6/24), thrombocytopenia (25.00%, 6/24), elevated C-reactive protein (91.67%, 22/24) and elevated adenosine deaminase (ADA) 91.67%, 22/24). Chest imaging abnormalities (16.67%, 4/24). With minocycline, doxycycline or azithromycin treatment, 23 cases recovered, 1 case of Epstein-Barr virus infection with toxic encephalitis. Conclusion From the beginning of November to the end of December, 2015, tsutsugamushi disease was the first time in Zhenjiang area in history. The clinical manifestations were typical, the diagnosis was clear, and some patients were seriously ill. Clinicians need to be identified in the work and early diagnosis and treatment.