Yang C H, Young T G, Peng M Y, Hsu G J
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 May;55(5):401-4.
Two young soldiers presented with acute abdomens, then received surgical procedures under initial impression of acute cholecystitis and acute appendicitis respectively. Operative findings did not confirm the initial diagnosis, and the clinical condition did not improve after operation. Scrub typhus was suggested later by clinical manifestations of fever, chills, headache, lymphadenopathy, skin rash and presence of eschar formation; this diagnosis was finally confirmed by positive serologic results of high Weil-Felix OXK agglutination and/or Rickettsia tsutsugammushi immunoflorescence titers in paired sera. Both patients rapidly became afebrile after administration of tetracycline. This unusual presentation with acute abdomen in scrub typhus is emphasized, with caution that the possibility of scrub typhus should be taken considered, especially in patients coming from hyperendemic areas.
两名年轻士兵出现急腹症，最初分别以急性胆囊炎和急性阑尾炎的印象接受了手术。手术所见未证实最初诊断，术后临床状况也未改善。后来，根据发热、寒战、头痛、淋巴结病、皮疹及焦痂形成等临床表现怀疑为恙虫病；最终通过双份血清中高效外斐OXK凝集试验和/或恙虫病立克次体免疫荧光滴度的阳性血清学结果确诊。两名患者在给予四环素后均迅速退热。强调了恙虫病这种不寻常的急腹症表现，提醒注意应考虑恙虫病的可能性，尤其是来自高流行区的患者。
