Eamsila C, Buranakitjaroen P, Tanskul P, Watcharapichat P
Division of Research, Royal Thai Army Component, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok.
J Med Assoc Thai. 1990 Oct;73(10):585-91.
Three patients, two of whom had eschars, were admitted with fulminant febrile disease suggestive of scrub typhus. Elevated IgG and IgM to Rickettsia tsutsugamushi were detected in all three by IFA. The cases lived in widely separated areas of western Bangkok where fruit trees are grown and claimed not to have left the areas of their homes during the estimated incubation periods. A field survey collected rodents, treeshrews, and mites fro around the homes of each case. R. tsutsugamushi was isolated from one rat and known vector species of mites were found. These are the first confirmed cases of scrub typhus transmission in Metropolitan Bangkok. It is suggested that typhus incidence around Bangkok may be substantial but has been unreported because of widespread self-medication with antibiotics and the difficulties of laboratory diagnosis.
三名患者因疑似恙虫病的暴发性发热疾病入院，其中两名患者有焦痂。通过间接荧光抗体试验在所有三名患者中均检测到针对恙虫病立克次体的IgG和IgM升高。这些病例居住在曼谷西部果树种植的广泛分散地区，并声称在估计的潜伏期内未离开过其家所在区域。一项现场调查在每个病例的家周围收集了啮齿动物、树鼩和螨虫。从一只大鼠中分离出恙虫病立克次体，并发现了已知的螨媒种类。这些是曼谷大都市地区首例确诊的恙虫病传播病例。有人认为，曼谷周围的恙虫病发病率可能很高，但由于抗生素的广泛自我用药以及实验室诊断的困难而未报告。
