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三级医疗中心内科收治的发热患者中的恙虫病:一项描述性横断面研究。

Scrub Typhus among Febrile Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

作者信息

Shrestha Sanjeeb, Pradhan Shanti, Shrestha Niranjan, Karn Mitesh

机构信息

Department of Biochemistry, Gandaki Medical College Teaching Hospital, Pokhara, Kaski, Nepal.

Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Kaski, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2023 Jul;61(263):576-579. doi: 10.31729/jnma.8208. Epub 2023 Jul 30.


DOI:10.31729/jnma.8208
PMID:40802744
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10395580/
Abstract

INTRODUCTION: Scrub typhus is an acute febrile illness caused by obligate intracellular bacteria of the family Rickettsia after an incubation period of 6-21 days. The disease may lead to several complications such as acute hepatitis, sepsis, myocarditis, respiratory distress and disseminated vasculitis if not treated properly. The aim of the study was to find out the prevalence of scrub typhus among febrile patients admitted to the Department of Medicine in a tertiary care centre. METHOD: This descriptive cross-sectional study was conducted among febrile patients admitted to the Department of Medicine in a tertiary care centre from 12 November 2020 to 11 May 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 26/076-077). All patients with acute febrile illness from 17 years to 70 years were included. Patients with an acute febrile illness diagnosed with other infections such as dengue, leptospirosis, typhoid, brucellosis, malaria, and COVID-19 were excluded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. RESULTS: Among 640 patients presenting with acute febrile illness, 38 (5.94%) (4.11-7.77, 95% Confidence Interval) patients were diagnosed to have scrub typhus. Among 38 patients, 2 (5.26%) patients suffered from acute hepatitis, and 1 (2.63%) each suffered from sepsis, myocarditis, disseminated vasculitis and respiratory distress. CONCLUSIONS: The prevalence of scrub typhus among patients admitted to the Department of Medicine was found to be slightly higher than in other studies done in similar settings.

摘要

引言:恙虫病是由立克次氏体科专性细胞内细菌引起的急性发热性疾病,潜伏期为6至21天。若治疗不当,该疾病可能导致多种并发症,如急性肝炎、败血症、心肌炎、呼吸窘迫和播散性血管炎。本研究的目的是了解在一家三级医疗中心内科收治的发热患者中恙虫病的患病率。 方法:本描述性横断面研究于2020年11月12日至2023年5月11日在一家三级医疗中心内科收治的发热患者中进行,研究获得了机构审查委员会的伦理批准(参考编号:26/076 - 077)。纳入所有年龄在17岁至70岁的急性发热性疾病患者。排除诊断为其他感染(如登革热、钩端螺旋体病、伤寒、布鲁氏菌病、疟疾和新冠肺炎)的急性发热性疾病患者。采用便利抽样法。计算点估计值和95%置信区间。 结果:在640例出现急性发热性疾病的患者中,38例(5.94%)(4.11 - 7.77,95%置信区间)被诊断为恙虫病。在38例患者中,2例(5.26%)患有急性肝炎,1例(2.63%)分别患有败血症、心肌炎、播散性血管炎和呼吸窘迫。 结论:在内科收治的患者中,恙虫病的患病率略高于在类似环境中进行的其他研究。

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本文引用的文献

[1]
Clinical profile and biochemical abnormalities in Scrub Typhus: A cross-sectional study.

Ann Med Surg (Lond). 2022-11-15

[2]
Seroprevalence of Scrub Typhus in Patients Attending Dhulikhel Hospital, Kavre.

Kathmandu Univ Med J (KUMJ).

[3]
An outbreak investigation of scrub typhus in Nepal: confirmation of local transmission.

BMC Infect Dis. 2021-2-18

[4]
Prevalence of scrub typhus in a tertiary care centre in Telangana, south India.

Iran J Microbiol. 2020-6

[5]
Case of scrub typhus complicated by severe disseminated intravascular coagulation and death.

Emerg Med Australas. 2012-10

[6]
Acute respiratory distress syndrome in scrub typhus.

Am J Trop Med Hyg. 2007-6

[7]
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Radiographics. 2007

[8]
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Emerg Infect Dis. 2006-10

[9]
Epidemiologic, clinical and laboratory features of scrub typhus in thirty Thai children.

Pediatr Infect Dis J. 2003-4

[10]
Rickettsial diseases: the typhus group of fevers--a review.

Postgrad Med J. 2000-5

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