McDonald J C, MacLean J D, McDade J E
McGill University Center for Tropical Disease, Montreal, Quebec, Canada.
Am J Med. 1988 Dec;85(6):799-805. doi: 10.1016/s0002-9343(88)80024-x.
The rickettsioses continue to constitute major health problems in many parts of the world. With increasing international travel, recognition of rickettsial diseases by physicians is becoming more important. The clinical features of four cases of rickettsial disease imported into Canada over a five-year period are presented; two patients with tick typhus (Rickettsia conorii), one patient with scrub typhus (R. tsutsugamushi), and one patient with murine typhus (R. typhi). We also present the North American data over the past 10 years from the Centers for Disease Control (CDC) (Atlanta).
Since 1983 in the United States, three cases of imported scrub typhus, all after travel to India, were confirmed, as well as six cases of murine typhus after travel to southeast Asia. At the CDC, 67 imported cases of tick typhus have been confirmed by indirect fluorescent antibody test since 1976; most illnesses occurred after travel to Africa.
Rickettsial diseases are underrecognized by physicians, who should consider these diagnoses in travelers returning from endemic areas. Since effective treatment is available, prompt diagnosis and treatment are important. In all cases, specific serologic confirmation should be obtained.
立克次体病在世界许多地区仍然是主要的健康问题。随着国际旅行的增加，医生对立克次体病的认识变得更加重要。本文介绍了5年期间输入加拿大的4例立克次体病的临床特征；2例患蜱传斑疹伤寒（康氏立克次体），1例患恙虫病（恙虫病东方体），1例患鼠型斑疹伤寒（伤寒立克次体）。我们还展示了过去10年美国疾病控制中心（位于亚特兰大）的北美数据。
自1983年以来，在美国确诊了3例输入性恙虫病，均为去过印度后发病，还有6例去过东南亚后发生鼠型斑疹伤寒。在疾病控制中心，自1976年以来，通过间接荧光抗体试验确诊了67例输入性蜱传斑疹伤寒；大多数病例是在去过非洲后发病。
立克次体病未得到医生的充分认识，医生应考虑对来自流行地区的旅行者进行这些疾病的诊断。由于有有效的治疗方法，及时诊断和治疗很重要。在所有病例中，都应进行特异性血清学确诊。
