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[恙虫病,智利一种新出现的传染病]

[Scrub typhus, an emerging infectious disease in Chile].

作者信息

Abarca Katia, Weitzel Thomas, Martínez-Valdebenito Constanza, Acosta-Jamett Gerardo

机构信息

Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.

出版信息

Rev Chilena Infectol. 2018;35(6):696-699. doi: 10.4067/S0716-10182018000600696.

Abstract

Scrub typhus, caused by Orientia tsutsugamushi and transmitted by larvae of trombiculid mites, is an endemic rickettsiosis in the Asia Pacific region. After the first identification of a case in Chile in 2006, more than 30 cases have been diagnosed by our group since 2015. Cases were detected predominantly during the Chilean summer months. Patients presented with fever, rash, and a typical eschar at the inoculation site; other frequent findings were intense headache, night sweats, increased laboratory markers of inflammation and transaminases. The vast majority of cases have been diagnosed in southern Chile (mainly Chiloé Island), although recently some cases were also identified in the central Metropolitan Region in patients returning from trips to southern Chile. Physicians attending Chilean patients should be aware of this emerging infection to be able to initiate empirical therapy with doxycycline. The confirmation of cases by the diagnostic methods available in Chile will contribute to a better understanding of the epidemiological and clinical relevance of this emerging infection in South America.

摘要

恙虫病由恙虫东方体引起,通过恙螨幼虫传播,是亚太地区的一种地方性立克次体病。自2006年在智利首次确诊一例病例后,自2015年以来我们团队已诊断出30多例病例。病例主要在智利夏季月份被发现。患者表现为发热、皮疹以及接种部位出现典型焦痂;其他常见症状为剧烈头痛、盗汗、炎症实验室指标和转氨酶升高。绝大多数病例在智利南部(主要是奇洛埃岛)被诊断出来,不过最近在首都大区中部也发现了一些病例,这些患者均来自去过智利南部旅行的人群。诊治智利患者的医生应了解这种新出现的感染,以便能够开始使用多西环素进行经验性治疗。通过智利现有的诊断方法确诊病例,将有助于更好地了解这种新出现的感染在南美洲的流行病学和临床相关性。

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