恙虫病的临床特征及重症恙虫病的早期诊断

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Abstract Objective: To explore the clinical characteristics of scrub typhus and analyze the risk factors of severe scrub typhus, which can provide reference for early diagnosis of severe scrub typhus. Methods: The clinical data of 81 cases of scrub typhus which came from the First Affiliated Hospitals of Wenzhou Medical University and the Second Affiliated Hospitals & Yuying Children’s Hospital of Wenzhou Medical University between January 2010 and August 2016 were retrospectively analyzed, then summarized the clinical characteristics of these patients. According to whether to stay in the ICU, all patients were dividived into two groups: severe scrub typhus group and non-severe scrub typhus group. Logistic regression was used to analyze the clinical features and laboratory tests of two groups, which can be used to identify factors associated with severe scrub typhus. Results: All patients showed different degree of fever and clinical symptoms of scrub typhus were various but lack of specificity; eighty-seven percent of the patients had eschar or ulcer; the reduction of eosinophil percentage and (or) count, elevation of alanine transaminase and aspertate aminotransferase laboratory tests were easeily to find. Logistic regression analysis found that there were significant differences, such as elevated white blood cell count (OR=1.401) and decreased platelet count (OR=0.087) between severe scrub typhus group and non-severe scrub typhus group. Conclusion: Eschar or ulcer was found in medical examination, the decreased of eosinophil percentage or count and increased of liver transaminase were found in laboratory tests in fever pantients are useful for the diagnosis of scrub typhus. Increased white blood cells and decreased platelets are the risk indicators related to severe scrub typhus.

Key words： severe scrub typhus risk factors early diagnosis

Received: 29 January 2017

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	WANG Ruili
	DAI Wei
	CHENG Bihuan
	CHEN Yongping
	GONG Yuqiang.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2017/V47/I11/836

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