Clinical Analysis Of 50 Cases With Acute Lung Injury/Acute Respiratory Distress Syndrome Caused By Tsutsugamushi Disease

Objective To study the clinical features of patients with acute lung injury /acute respiratory distress syndrome(ALI/ARDS)caused by tsutsugamushi disease and to deepen the understanding of the disease.Data and Methods The clinical data of 12 patients with ALI/ARDS caused by tsutsugamushi disease from 2001 to 2006 were analysed retrospectively by signs and symptoms,chest radiographs,blood gas analysis and condition of misdiagnosis.Of all patients 50%(6/12)were initially misdiagnosed as other disease.All cases had cough and dyspnea;10 patients had hyperpyrexia(83%),9 patients had generalized muscle ache(75%).All cases had rales.Lymphadenectasis(91%),eschar(83%),rash(67%)and conjunctival congestion(50%)have higher rate in the physical sign.ChestX-rays:58.3% (7/12)showed pulmonary interstitial inflammatory lesion.Weil-Felix test:75% (9/12)showed positive result(≥1:160).Treated by the combined usage of Chloromycefin,Tetracycline,Quinolone and breathing support therapies,9 patients(75%)were healing well,3 patients(25%)were death.Conclusions 1.More attention should be paid to patients with ALI/ARDS caused by tsutsugamushi disease to avoid misdiagnosis.2.Eschar and rash are more important in the physical sign.Usage of the combination of Chest X-rays,Weil-felix test and clinical manifestation was proved to have higher clinic value in diagnosis of ALI/ARDS caused by tsutsugamushi disease.3.The combined usage of Chloromycefin,Tetracycline,Quinolone and breathing support therapies was effective in most part cases.The prognosis was good if diagnosed and treated properly at an early stage.