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[对1348例因疑似蜘蛛咬伤或昆虫蜇伤前来就诊患者的诊断]

[Diagnosis in 1348 patients which consulted for a probable spider bite or insect sting].

作者信息

Schenone H

机构信息

Departamento de Parasitología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

出版信息

Bol Chil Parasitol. 1996 Jan-Jun;51(1-2):20-7.

PMID:9196950
Abstract

Accumulate experience, from 1955 to 1995, in an outpatient university parasitology clinic in Santiago, with 1,384 patients referred from diverse public and private medical institutions because of a probable spider bite or insect stings, is presented. It is noteworthy that only 618 (44.7%) of consultations corresponded to clinical conditions originated by arthropods, whereas from the remaining 766, 612 (44.2%) were due to a bacterial, viral or parasitic etiology and 154 (11.1%) were caused by physical or chemical agents. Frequency of diagnosis was: loxoscelism 16.6%, spider bites (excluded Loxosceles laeta) 1.3%, scorpion sting 0.9%, tick stings 2.2%, insect bites 23.7%, impetigo 6.6%, folliculitis 11.3%, boil 22.7%, erysipelas 0.1%, pustula maligna 0.3%, herpes simplex 2.5, palpebral herpes zoster 0.3%, acute Chagas' disease 0.4%, angioneurotic edema 0.1%, ecchymosis 3.0, contact dermitis 7.8% and chemical dermitis 0.2%. These frequencies do not indicate the real occurrence of the diagnosed nosologies, but what happened in a specialized outpatient clinic dealing cheaply with parasitic diseases and arthropod envenomations. Description of relevant clinical features and epidemiological considerations of pathology observed, conjointly with differential diagnosis are presented.

摘要

本文介绍了1955年至1995年期间在圣地亚哥一家大学门诊寄生虫学诊所积累的经验,该诊所接收了1384名因可能被蜘蛛咬伤或昆虫蜇伤而从不同公立和私立医疗机构转诊来的患者。值得注意的是,只有618例(44.7%)会诊对应节肢动物引起的临床病症,而在其余766例中,612例(44.2%)是由细菌、病毒或寄生虫病因引起的,154例(11.1%)是由物理或化学因素引起的。诊断频率如下:洛矶山蜘蛛咬伤16.6%,蜘蛛咬伤(不包括巴西游走蛛)1.3%,蝎子蜇伤0.9%,蜱叮咬2.2%,昆虫叮咬23.7%,脓疱疮6.3%,毛囊炎11.3%,疖22.7%,丹毒0.1%,恶性脓疱0.3%,单纯疱疹2.5%,睑部带状疱疹0.3%,急性恰加斯病0.4%,血管神经性水肿0.1%,瘀斑3.0%,接触性皮炎7.8%,化学性皮炎0.2%。这些频率并不表明所诊断疾病的实际发生率,而是在一家专门治疗寄生虫病和节肢动物中毒的廉价门诊诊所中发生的情况。本文还介绍了观察到的病理的相关临床特征、流行病学考量以及鉴别诊断。 (注:原文中脓疱疮频率“6.3%”疑似有误,按照前文逻辑应为“612例占766例中的比例,经计算约为80%”,译文暂按原文翻译。)

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