Chinese People's Liberation Army General Hospital, Department of Hospital Infection Control, Beijing, People's Republic of China.
Pediatr Infect Dis J. 2009 Dec;28(12):1111-4. doi: 10.1097/INF.0b013e3181af8287.
Scrub typhus emerged in northern China in 1986. Our objective was to document epidemiologic, clinical and laboratory features of pediatric scrub typhus in this new endemic area.
The pediatric patients diagnosed with scrub typhus during the 12-year period from 1995 through 2006 in Feixian County, Shandong province were enrolled in the study. The cases were diagnosed based on either specific antibody detection using the indirect immunofluorescent assay or detection of partial Orientia tsutsugamushi gene by polymerase chain reaction.
Seventy pediatric scrub typhus cases were included in the study. The cases occurred from September through November. The common clinical manifestations included headache (100%), skin rash (91%), eschar (84%), lymphadenopathy (61%), and gastrointestinal signs (56%). None of the patients had neurologic involvement or thrombocytopenia. All children responded well to treatment with chloramphenicol. The patients who presented with abnormal chest radiography took significantly longer time to defervescence (Z[r] = 2.528, P = 0.011). Three strains of O. tsutsugamushi were isolated and all were identified as Kawasaki type.
The manifestations of pediatric scrub typhus cases in the novel endemic region of northern China may be less severe than in other regions. Careful examination of skin eschars is helpful for the clinical diagnosis.
恙虫病于 1986 年在中国北方出现。我们的目的是记录在这个新疫区儿科恙虫病的流行病学、临床和实验室特征。
在山东省费县，1995 年至 2006 年的 12 年期间，对被诊断患有恙虫病的儿科患者进行了研究。病例的诊断依据是间接免疫荧光检测到的特异性抗体或聚合酶链反应检测到的部分恙虫东方体基因。
本研究共纳入 70 例儿科恙虫病患者。病例发生在 9 月至 11 月。常见的临床表现包括头痛（100%）、皮疹（91%）、焦痂（84%）、淋巴结肿大（61%）和胃肠道症状（56%）。无患者有神经系统受累或血小板减少症。所有儿童对氯霉素治疗反应良好。出现异常胸部 X 线表现的患者退热时间明显延长（Z[r] = 2.528，P = 0.011）。分离出的 3 株恙虫东方体均为川崎型。
中国北方新疫区儿科恙虫病患者的临床表现可能较其他地区轻。仔细检查皮肤焦痂有助于临床诊断。
