Sun Ming, Wang Dong-Liang, Zhao Chun-Yun, Chen Qiu-Xiang
Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Suqian 223800, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2013 Dec;25(6):639-41.
To understand the clinical characteristics of tsutsugamushi disease in Suqian Municipality, Jiangsu Province so as to guide the diagnosis and treatment of this disease.
The clinical data of 32 patients diagnosed as tsutsugamushi disease in our hospital during the past 2 years were analyzed retrospectively.
Tsutsugamushi disease occurred frequently between August and December. All the 32 patients had the history of contacting grass and brushwood, and all of them showed the signs of pyrexia, eschar, ulcer, swelling of lymph nodes and rash. Liver damages were observed in 30 cases (93.75%). Pulmonary imaging changes were observed in 14 cases (43.75%). Heart damages were noticed in 9 cases (28.13%). Kidney damages were noticed in 6 cases (18.75%). One case was complicated by multiple organ dysfunction syndromes (MODS) and disseminated intravascular coagulation (DIC). The OX19 and OX2 antigen agglutination reaction of bacillus proteus were negative in all the cases. The OXK antigen agglutination reaction of bacillus proteus was positive in 6 cases (18.75%). Among 32 cases, 24 cases were misdiagnosed in the first visiting clinic. The misdiagnosis rate of the initial diagnosis of this disease reached as high as 75%. Azithromycin was effective. The curative rate was 96.88% and the mortality was 3.13% (1 case).
Clinical characteristics of tsutsugamushi disease are complicated, and it is commonly complicated with liver damages. The Weil-Felix test is not very important to initial diagnosis for tsutsugamushi disease in local. For patients as fever with unknown origin (FUO) and with the liver damage, the diagnosis of tsutsugamushi disease should be reminded.
