Chanta Chulapong, Chanta Suwalee
Pediatric Unit, Chiang Rai Prachanukraw Hospital, Chiang Rai 57000, Thailand.
J Med Assoc Thai. 2005 Dec;88(12):1867-72.
20 children, diagnosed with scrub typhus who attended Chiang Rai Regional Hospital during a period of 6 months from June 2003 to December 2003, were studied prospectively. All cases were serologically proved to be scrub typhus by using Dipstick or indirect immunofluorescent antibody (IFA) technique. The most common clinical feature was eschar (75%). Others included hepatomegaly (65%), cough (60%), lymphadenopathy (40%), tachypnea (35%), constipation (25%), abdominal pain (20%), edema (20%), splenomegaly (15%), vomiting (15%), rash (15%) and petichia (5%) respectively. Chest radiography showed abnormalities in 85% with mostly bilateral interstitial infiltrations. Elevated of SGOT: SGPT were detected in 18 (90%) and 15 (75%) cases. Hypoalbuminemia was detected in 12 (60%) cases. Complete blood count showed PMN leukocytosis (> 60%) in 12 (60%) cases, lymphocytosis (> 40%) and atypical lymphocytosis (> 5%) in 1 (5%) case each and thrombocytopenia in 16 (80%) cases. The Weil-Felix test was positive in 1 (5%) case. Complications were pneumonia with or without pulmonary edema, meningitis and shock. Chloramphenicol and doxycycline were successfully treated and roxithromycin was not effective.
对2003年6月至2003年12月期间在清莱地区医院就诊的20例恙虫病确诊患儿进行了前瞻性研究。所有病例均通过试纸条法或间接免疫荧光抗体（IFA）技术血清学确诊为恙虫病。最常见的临床特征是焦痂（75%）。其他特征分别为肝肿大（65%）、咳嗽（60%）、淋巴结病（40%）、呼吸急促（35%）、便秘（25%）、腹痛（20%）、水肿（20%）、脾肿大（15%）、呕吐（15%）、皮疹（15%）和瘀点（5%）。胸部X线检查显示85%有异常，主要为双侧间质性浸润。18例（90%）检测到谷草转氨酶（SGOT）升高，15例（75%）检测到谷丙转氨酶（SGPT）升高。12例（60%）检测到低白蛋白血症。全血细胞计数显示，12例（60%）中性粒细胞增多（>60%），1例（5%）淋巴细胞增多（>40%）且异型淋巴细胞增多（>5%），16例（80%）血小板减少。外斐试验1例（5%）呈阳性。并发症包括伴有或不伴有肺水肿的肺炎、脑膜炎和休克。氯霉素和强力霉素治疗成功，而罗红霉素无效。
