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[Clinical characteristics of 32 cases of tsutsugamushi disease in Suqian Municipality].
[scrub typhus]
To
understand
the
clinical
characteristics
of
tsutsugamushi
disease
in
Suqian
Municipality
,
Jiangsu
Province
so
as
to
guide
the
diagnosis
and
treatment
of
this
disease
.
The
clinical
data
of
32
patients
diagnosed
as
tsutsugamushi
disease
in
our
hospital
during
the
past
2
years
were
analyzed
retrospectively
.
Tsutsugamushi
disease
occurred
frequently
between
August
and
December
.
All
the
32
patients
had
the
history
of
contacting
grass
and
brushwood
,
and
all
of
them
showed
the
signs
of
pyrexia
,
eschar
,
ulcer
,
swelling
of
lymph
nodes
and
rash
.
Liver
damages
were
observed
in
30
cases
(
93
.
75
%
)
.
Pulmonary
imaging
changes
were
observed
in
14
cases
(
43
.
75
%
)
.
Heart
damages
were
noticed
in
9
cases
(
28
.
13
%
)
.
Kidney
damages
were
noticed
in
6
cases
(
18
.
75
%
)
.
One
case
was
complicated
by
multiple
organ
dysfunction
syndromes
(
MODS
)
and
disseminated
intravascular
coagulation
(
DIC
)
.
The
OX
19
and
OX
2
antigen
agglutination
reaction
of
bacillus
proteus
were
negative
in
all
the
cases
.
The
OXK
antigen
agglutination
reaction
of
bacillus
proteus
was
positive
in
6
cases
(
18
.
75
%
)
.
Among
32
cases
,
24
cases
were
misdiagnosed
in
the
first
visiting
clinic
.
The
misdiagnosis
rate
of
the
initial
diagnosis
of
this
disease
reached
as
high
as
75
%
.
Azithromycin
was
effective
.
The
curative
rate
was
96
.
88
%
and
the
mortality
was
3
.
13
%
(
1
case
)
.
Clinical
characteristics
of
tsutsugamushi
disease
are
complicated
,
and
it
is
commonly
complicated
with
liver
damages
.
The
Weil-
Felix
test
is
not
very
important
to
initial
diagnosis
for
tsutsugamushi
disease
in
local
.
For
patients
as
fever
with
unknown
origin
(
FUO
)
and
with
the
liver
damage
,
the
diagnosis
of
tsutsugamushi
disease
should
be
reminded
.
Diseases
Validation
Diseases presenting
"liver damage"
symptom
benign recurrent intrahepatic cholestasis
erythropoietic protoporphyria
neonatal adrenoleukodystrophy
scrub typhus
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