| ObjectiveScrub typhus is a type of naturally-occurring infectious disease caused by Orientia tsutsugamushi,a mite-borne bacterium belonging to the family Rickettsiaceae.In the past 10 years,the incidence of scrub typhus has been on the rise.Misdiagnosis or missed diagnosis by the first doctor is one of the factors contributing to the high mortality rate of scrub typhus.Therefore,to analyze the clinical characteristics of scrub typhus and reduce misdiagnosis or missed diagnosis is an effective means to reduce the mortality.This paper analyzed the clinical characteristics,laboratory examination,pathological characteristics and so on of 34 tsutsugamushi patients found in sheyang area from 2017 to 2018.MethodsThis study includes 34 cases of scrub typhus patients diagnosed in the dermatology outpatient and inpatient department of Sheyang People's hospital from 2017 to 2018.The epidemiological characteristics,pattern of fever,fever process,clinical symptoms,basic diseases,laboratory examination,pathology,treatment and outcome of 34 patients were analyzed.Laboratory tests included routine blood test,liver and kidney function tests,C-reactive protein and proteus OXK agglutination test(Weil-Felix test).All laboratory tests were performed on the second day after hospitalization or samples were taken on the second day after outpatient service.SPSS 17.0 software was used for statistical analysis,and measurement data were expressed as x ± s.Two independent samples t-test were used for inter-group comparison,and chi-square test and Fisher's exact probability method was used for inter-group comparison of grade data.P <0.05 was considered statistically significant.ResultsAmong the 34 patients,there were 20 males(58.82%)and 14 females(41.18%).The average age was(62.21±11.34).There was no statistically significant difference between the two groups with regards to sex(P >0.05),and no statistically significant difference in gender,whether or not a dermatologist visited the hospital,or the year of treatment(P >0.05).The incidence rate in male farmers was significantly lower than that in female farmers(P <0.05).Fever and eschar developed in all patients.According to the grouping of gender,age,occupation and abnormal ALT,the results showed that there were no significant differences between male and female patients in all laboratory indicators(P >0.05).CRP and CREA were significantly higher in the age group(>65 years old)than those in the age group(<65 years old)(P <0.05).The percentage of basophilic granulocytes and UA were significantly lower in patients with farmer occupation than in patients with non-farmer occupation(P <0.05).CRP was significantly higher than that of non-farmer patients(P <0.05).The percentage of basophilic granulocytes,AST,GGT and ALP in patients with normal ALT group were significantly lower than those in patients with abnormal ALT group.There were only 3 patients with positive test in Weil-Felix test.A total of 31 patients underwent skin biopsy,and all patients showed necrotic scab(100%)in the epidermis,and most patients showed perivascular inflammation within the dermis(90.32%).ConclusionThe incidence of scrub typhus in the 2017-2018 population in Sheyang district is relatively high in the higher age group;the main clinical manifestations were fever and eschar;the main pathological manifestations of eschar were superficial eschar and inflammatory cell infiltration around dermal vessels. |
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