Rajapakse Senaka, Weeratunga Praveen, Sivayoganathan Sriharan, Fernando Sumadhya Deepika
Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo 08, Sri Lanka.
University Medical Unit, National Hospital, Regent Street, Colombo 08, Sri Lanka.
Trans R Soc Trop Med Hyg. 2017 Feb 1;111(2):43-54. doi: 10.1093/trstmh/trx017.
The mite-borne rickettsial zoonosis scrub typhus is widely prevalent in parts of Southeast and Far East Asia, and northern Australia. The disease is an acute febrile illness, associated with rash and often an eschar, which responds dramatically to treatment with antibiotics. In some cases it results in a serious illness leading to multiple organ involvement and death. The disease manifestations are thought to result from a systemic vasculitis, caused by both direct effects of the organisms as well as an exaggerated immune response, although little is understood about its pathogenesis. A wide spectrum of clinical manifestations, affecting nearly every organ system, have been described with scrub typhus. Some of these manifestations are serious and life threatening. In this systematic review, we summarise the typical and atypical manifestations of scrub typhus reported in the literature. Awareness of these unusual manifestations will hopefully guide clinicians towards diagnosing the condition early, and initiating early appropriate antibiotics and other supportive measures.
由螨传播的立克次氏体人畜共患病恙虫病在东南亚、远东部分地区及澳大利亚北部广泛流行。该病是一种急性发热性疾病，伴有皮疹，常出现焦痂，对抗生素治疗反应显著。在某些情况下，它会导致严重疾病，引起多器官受累甚至死亡。尽管对其发病机制了解甚少，但一般认为疾病表现是由病原体的直接作用以及过度免疫反应导致的全身性血管炎引起的。文献中已描述了恙虫病广泛的临床表现，几乎累及每个器官系统。其中一些表现严重且危及生命。在本系统评价中，我们总结了文献报道的恙虫病的典型和非典型表现。希望对这些不寻常表现的认识能指导临床医生早期诊断该病，并尽早开始适当的抗生素治疗及其他支持措施。
