Silpapojakul K
Department of Medicine, Prince of Songkla University, Songkla, Thailand.
Ann Acad Med Singap. 1997 Nov;26(6):794-800.
Scrub typhus is widely endemic in Asia. Man's behaviour and climatic changes greatly influenced the occurrence of the disease. Increasing prevalences of scrub typhus have been reported from some Asian countries and may coincide with the widespread use of beta-lactam antibiotics or to improve diagnostic facilities and/or more urbanisation into rural areas. Many cases acquired in Asia surfaced in Europe and America. The disease probably is overlooked among paediatric patients. Most patients with scrub typhus present with acute fever of unknown origin (acute FUO). Eschars are rare among Southeast Asian patients. Complications usually develop after the first week of illness. The complications include pneumonitis, meningoencephalitis, renal failure and jaundice. Improved serologic and molecular diagnostic tests are now available. Although drug-resistant strain of Orientia tsutsugamushi has been reported, the infection usually responds to simple but unpopular drugs such as doxycycline or chloramphenicol.
恙虫病在亚洲广泛流行。人类行为和气候变化对该病的发生有很大影响。一些亚洲国家报告恙虫病发病率不断上升，这可能与β-内酰胺类抗生素的广泛使用、诊断设施的改善和/或农村地区城市化程度提高有关。在亚洲感染的许多病例出现在欧洲和美洲。这种疾病在儿科患者中可能被忽视。大多数恙虫病患者表现为不明原因的急性发热（急性不明原因发热）。东南亚患者中焦痂罕见。并发症通常在发病第一周后出现。并发症包括肺炎、脑膜脑炎、肾衰竭和黄疸。现在有了改进的血清学和分子诊断测试。虽然已经报道了对恙虫病东方体耐药的菌株，但这种感染通常对强力霉素或氯霉素等简单但不太常用的药物有反应。
