中国感染控制杂志2025，Vol.24Issue(6)：776-781,6.DOI:10.12138/j.issn.1671-9638.20257009
9例重症日本斑点热病例临床特征及治疗方案分析
Clinical characteristics and treatment scheme of 9 patients with severe Japanese spotted fever
摘要
Abstract
Objective To analyze the clinical characteristics and treatment schemes of patients with severe Japa-nese spotted fever(JSF),and provide a basis for the diagnosis and treatment of severe JSF.Methods Data of JSF patients who admitted to Yichang Central People's Hospital from April 2022 to September 2024 were collected,and severe patients were selected for analysis.Epidemiological and clinical characteristics,as well as treatment schemes were investigated.Results A total of 19 JSF patients were admitted,including 10 mild cases and 9 severe cases.All 9 severe cases(100％)had a history of outdoor activities.All patients presented with multiple organ dysfunc-tion besides symptoms such as fever,rash,fatigue,poor appetite,and scab.Laboratory examination results were as follows:white blood cell count and neutrophil percentage elevated in 5(55.6％)and 9(100％)cases,respective-ly;lymphocyte percentage and platelets decreased in 9(100％)and 8 cases(88.9％),respectively;C-reactive pro-tein increases significantly in 9 cases(100％);alanine aminotransferase and aspartate aminotransferase increased in 9 cases(100％)and 8 cases(88.9％),respectively;total protein,albumin,and albumin/globulin ratio decreased in 6 cases(66.7％)and 9 cases(100％),respectively;blood sodium and blood calcium decreased in 3(33.3％)and 9 cases(100％),respectively;urea elevated in 8 cases(88.9％);creatinine,lactic dehydrogenase and α-hydroxybu-tyrate,and creatine kinase isoenzyme elevated in 6(66.7％),9(100％),and 4 cases(44.4％),respectively.In terms of treatment,all patients were treated with doxycycline combined with other antimicrobial agents.Six pa-tients(66.7％)received tracheal intubation for ventilator-assisted ventilation;8 patients(88.9％)received infusion of blood products such as platelets and plasma;9 patients(100％)received infusion of albumin and support treat-ment such as liver and stomach protection,water and electrolyte balance maintenance,et al;6 patients(66.7％)were finally cured.Conclusion Severe JSF not only causes typical symptoms such as fever,rash,and scab,but also leads to multiple organ dysfunction.Timely application of doxycycline supportive treatment for various organs can help patients get through the critical period and receive effective treatment.关键词
重症日本斑点热/多器官功能障碍/临床特征/治疗方法/日本立克次体Key words
severe Japanese spotted fever/multiple organ dysfunction/clinical characteristics/treatment method/Japanese rickettsia分类
医药卫生引用本文复制引用
张庆勇,龚萍..9例重症日本斑点热病例临床特征及治疗方案分析[J].中国感染控制杂志,2025,24(6):776-781,6.基金项目
中国疾病预防控制中心传染病预防控制国家重点实验室开放项目(2022SKLID304) （2022SKLID304）
湖北省自然科学基金创新发展联合基金项目(2024AFD145) （2024AFD145）
