Scrub Typhus: Surveillance, Clinical Profile and Diagnostic Issues in Shandong, China
Scrub Typhus: Surveillance, Clinical Profile and Diagnostic Issues in Shandong, China
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中国山东省恙虫病的监测、临床概况和诊断问题
DOI：
10.4269/ajtmh.2012.12-0306
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发表时间：
2012-12-01
影响因子：
3.3
通讯作者：
Ding, Shu-Jun
中科院分区：
文献类型：
--
作者：
Zhang, Meng;Zhao, Zhong-Tang;Ding, Shu-Jun
为了解山东省恙虫病的流行现状、临床特征和诊断问题，对2006 - 2011年山东省恙虫病监测资料进行分析，并于2010年开展了以医院为基础的疾病调查。恙虫病在山东省山区和沿海地区聚集，流行期为9 ~ 11月。最常见的临床表现为发热（100%）、焦痂或皮肤溃疡（86.3%）、乏力（71.6%）、厌食（71.6%）、皮疹（68.6%）。主要并发症包括支气管肺炎、中毒性肝炎和急性胆囊炎，分别占21.6%、3.9%和2.9%。严重并发症包括中毒性心肌炎、心力衰竭、肺水肿、胸腔积液和肺气肿在山东首次报道。当地医疗机构对恙虫病的漏诊和延误诊断现象普遍。对新近暴发的恙虫病流行区恙虫病的临床特征变化和目前诊断问题应引起警惕。
To elucidate the epidemic status, clinical profile, and current diagnostic issues of scrub typhus in Shandong Province, we analyzed the surveillance data of scrub typhus from 2006 to 2011 and conducted a hospital-based disease survey in 2010. Scrub typhus was clustered in mountainous and coastal areas in Shandong Province, with an epidemic period from September to November. The most common manifestations were fever (100%), eschar or skin ulcer (86.3%), fatigue (71.6%), anorexia (71.6%), and rash (68.6%). Predominant complications included bronchopneumonia, toxic hepatitis, and acute cholecystitis in 21.6%, 3.9%, and 2.9% of the cases, respectively. Severe complications including toxic myocarditis, heart failure, pneumonedema, pleural effusion, and emphysema were first reported in Shandong. Missed and delayed diagnosis of scrub typhus was common in local medical institutions. Alarm should be raised for changes of clinical features and current diagnostic issues of scrub typhus in newly developed endemic areas.