Silpapojakul Kamkarn, Varachit Boonyarat, Silpapojakul Khachornsakdi
Department of Paediatrics, Hat-yai Hospital, Hat-yai, Songkla, Thailand.
Trans R Soc Trop Med Hyg. 2004 Jun;98(6):354-9. doi: 10.1016/j.trstmh.2003.10.011.
We studied 73 Thai children with scrub typhus (median age 9 years, range 3-14 years, male:female ratio 1.8:1). Most patients (86%) lived in rural areas. They presented with subacute fever (median, 9 d) with vomiting (35%), hepatomegaly (59%), splenomegaly (18%), and tachypnea (26%). Skin rash (7%), eschar (7%), and history of mite bite were rare. Blood leucocyte counts were usually normal but 19% of patients were thrombocytopenic. Twenty (22%) patients had pneumonia and six (8%) had neurological involvement. Defervescence occurred a median of 1 d and 3 d after initiation of doxycycline and chloramphenicol, respectively, and these responses were more rapid than in those who received other antibiotics or no treatment (P < 0.001). There was one death. Only 55% of the patients were initially diagnosed as having scrub typhus.
我们研究了73例恙虫病泰国儿童（中位年龄9岁，范围3 - 14岁，男女比例1.8:1）。大多数患者（86%）生活在农村地区。他们表现为亚急性发热（中位时间9天），伴有呕吐（35%）、肝肿大（59%）、脾肿大（18%）和呼吸急促（26%）。皮疹（7%）、焦痂（7%）和螨虫叮咬史少见。血常规白细胞计数通常正常，但19%的患者有血小板减少。20例（22%）患者有肺炎，6例（8%）有神经系统受累。分别在开始使用多西环素和氯霉素后中位时间1天和3天体温下降，这些反应比接受其他抗生素治疗或未治疗的患者更快（P < 0.001）。有1例死亡。仅有55%的患者最初被诊断为恙虫病。
