Ren Yuting, Jiang Yale, Xiang Zhoufu, Cheng Qi, Chen Kehan, Ma Jianchun, Dai Jianwei, Zhang Weihao, Hou Wei, Liu Qiang, Chen Liangjun
State Key Laboratory of Virology and Biosafety, Institute of Medical Virology, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Wuhan, Hubei, China.
Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, China.
Transbound Emerg Dis. 2025 Jul 25;2025:4832524. doi: 10.1155/tbed/4832524. eCollection 2025.
Japanese spotted fever (JSF) is an easily neglected infectious disease, where misdiagnosis and delayed treatment significantly contribute to poor prognoses in affected patients. Our prospective observational study (2021-2023) systematically characterized 56 JSF cases in Yichang through tripartite analysis encompassing epidemiological distributions, clinical phenotyping, and phylogenetic relationship analysis of (). Our study delineated distinct clinical presentations of JSF, and identified five laboratory indexes demonstrating significant associations with disease severity. Notably, thrombocytopenia (platelet deficiency) and procalcitonin (PCT) levels emerged as critical indicators, with PCT as a well-characterized inflammatory mediator showing particular prognostic value for anticipating severe complications in rickettsial infections, consistent with prior pathophysiological research. Phylogenetic analysis revealed that strains distributed in Yichang City exhibited extremely low genomic diversity. Further, the strains isolated in our study exhibited a high degree of homology with isolation within the borders of China. In summary, our research identified several factors that indicate a high risk of poor outcomes in infections. Additionally, we observed highly similar phylogenetic relationships among strains, which have important implications for disease prevention, control, and clinical diagnosis.
日本斑点热（JSF）是一种容易被忽视的传染病，误诊和治疗延迟会显著导致受影响患者的预后不良。我们的前瞻性观察研究（2021 - 2023年）通过包括流行病学分布、临床表型分析以及（）的系统发育关系分析在内的三方分析，对宜昌市的56例日本斑点热病例进行了系统特征描述。我们的研究描绘了日本斑点热不同的临床表现，并确定了五个与疾病严重程度有显著关联的实验室指标。值得注意的是，血小板减少（血小板缺乏）和降钙素原（PCT）水平成为关键指标，PCT作为一种特征明确的炎症介质，对预测立克次体感染的严重并发症具有特别的预后价值，这与先前的病理生理学研究一致。系统发育分析表明，分布在宜昌市的菌株表现出极低的基因组多样性。此外，我们研究中分离出的菌株与中国境内分离出的菌株具有高度同源性。总之，我们的研究确定了几个表明感染预后不良高风险的因素。此外，我们观察到菌株之间具有高度相似的系统发育关系，这对疾病的预防、控制和临床诊断具有重要意义。
