Kantipong P, Watt G, Jongsakul K, Choenchitra C
Department of Medicine, Chiangrai Regional Hospital, Thailand.
Clin Infect Dis. 1996 Nov;23(5):1168-70. doi: 10.1093/clinids/23.5.1168.
Infection by Orientia (formerly Rickettsia) tsutsugamushi causes scrub typhus, a severe febrile disease common in Asia. Both scrub typhus and AIDS are prevalent in northern Thailand. Therefore, we prospectively investigated the impact of infection due to human immunodeficiency virus (HIV) on the severity of the clinical syndrome produced by O. tsutsugamushi. The severity of scrub typhus was objectively graded on admission of patients to the hospital, and serologies for antibodies to HIV were performed. Fourteen (16%) of 86 patients with scrub typhus were infected with HIV; the median T helper cell count was 70/mm3. There were no significant differences between HIV-infected patients and non-HIV-infected patients in severity scores or other admission characteristics. O. tsutsugamushi was isolated in blood samples from 48.6% of patients without HIV infection and in blood samples from 14.3% of HIV-infected patients (P < .05 x 2 test). The clinical manifestations of O. tsutsugamushi infection, unlike those due to some other intracellular pathogens, are not unusually severe in immunocompromised patients with AIDS.
恙虫病东方体（以前称为立克次体）感染可引发恙虫病，这是一种在亚洲常见的严重发热性疾病。恙虫病和艾滋病在泰国北部都很普遍。因此，我们前瞻性地研究了人类免疫缺陷病毒（HIV）感染对恙虫病东方体所致临床综合征严重程度的影响。在患者入院时对恙虫病的严重程度进行客观分级，并检测HIV抗体的血清学指标。86例恙虫病患者中有14例（16%）感染了HIV；辅助性T细胞计数中位数为70/mm³。HIV感染患者和未感染HIV患者在严重程度评分或其他入院特征方面没有显著差异。在未感染HIV患者的血样中，48.6%分离出了恙虫病东方体，而在感染HIV患者的血样中，这一比例为14.3%（P<0.05，卡方检验）。与其他一些细胞内病原体不同，恙虫病东方体感染在艾滋病免疫功能低下患者中的临床表现并不异常严重。
