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恙虫病患者焦痂分布特征研究(附249例报告)

冯基花 曾诚 张剑锋

临床误诊误治Issue(4):9-11,3.
临床误诊误治Issue(4):9-11,3.DOI:10.3969/j.issn.1002-3429.2015.04.003

恙虫病患者焦痂分布特征研究(附249例报告)

Distribution of Eschar in Patients with Scrub Typhus

冯基花 1曾诚 2张剑锋1

作者信息

  • 1. 530007 南宁,广西医科大学第一附属医院急诊科
  • 2. 545006 广西壮族自治区柳州,柳州市人民医院急诊科
  • 折叠

摘要

Abstract

Objective To investigate the preferential sites of eschars over the bodies of patients with tsutsugamushi disease, in order to improve clinical diagnosis of scrub typhus. Methods In a retrospective analysis, we analyzed 249 pa-tients with scrub typhus in the first affiliated hospital of Guangxi Medical University and Liuzhou People's Hospital during Janu-ary 2009 and July 2014, focusing on the distribution of eschars and the relationships between gender, age and residence place. Results In our study, there were 3 patients with no eschar, accounting for 1. 2% and 246 patients (98. 8%) with es-char, 252 in total. The distribution of eschars over the body was: on perineum, genitalia, groin and buttocks, 76 cases (30. 2%);on chest and abdomen, 56 cases (22. 2%);on axillary fossa and breasts, 39 cases (15. 5%);on back, 31 ca-ses (12. 3%);on head, on neck and face there were 18 cases (7. 1%);on upper extremities 17 cases (6. 7%);on lower extremities, 15 cases (6. 0%). There was a difference in the distribution of eschars between males and females(P<0. 05), for males they were mainly distributed in the area of perineum and the groin, while for females, they were distributed in the ar-ea of breasts and axillary fossa. The distribution of eschars in different age and residence groups were mainly on perineum, genitalia, groin and buttocks, but the occurrence rate on back in the young and old group was higher than that of the adult group(P<0. 05), and the occurrence rate of the upper extremities in the rural group was higher than that of the urban group ( P<0. 05).Conclusion The eschar is an important clue in diagnosis of scrub typhus, and thorough examinations should be performed for the patients who run a fever accompanied with lymphadenopathy, enlarged liver and spleen and rash, especially over perineum, genitalia and groin in males, axillary fossa and breasts in females in order to prevent misdiagnosis.

关键词

丛林斑疹伤寒/焦痂/分布/误诊

Key words

Scrub typhus/Eschar/Distribution/Misdiagnosis

分类

医药卫生

引用本文复制引用

冯基花,曾诚,张剑锋..恙虫病患者焦痂分布特征研究(附249例报告)[J].临床误诊误治,2015,(4):9-11,3.

基金项目

广西科学研究与技术开发计划课题(桂科攻14124003-7) (桂科攻14124003-7)

临床误诊误治

OACSTPCD

1002-3429

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