[Clinical characteristics of 32 cases of tsutsugamushi disease in Suqian Municipality].
OBJECTIVE
To understand the clinical characteristics of tsutsugamushi disease in Suqian Municipality, Jiangsu Province so as to guide the diagnosis and treatment of this disease.


METHODS
The clinical data of 32 patients diagnosed as tsutsugamushi disease in our hospital during the past 2 years were analyzed retrospectively.


RESULTS
Tsutsugamushi disease occurred frequently between August and December. All the 32 patients had the history of contacting grass and brushwood, and all of them showed the signs of pyrexia, eschar, ulcer, swelling of lymph nodes and rash. Liver damages were observed in 30 cases (93.75%). Pulmonary imaging changes were observed in 14 cases (43.75%). Heart damages were noticed in 9 cases (28.13%). Kidney damages were noticed in 6 cases (18.75%). One case was complicated by multiple organ dysfunction syndromes (MODS) and disseminated intravascular coagulation (DIC). The OX19 and OX2 antigen agglutination reaction of bacillus proteus were negative in all the cases. The OXK antigen agglutination reaction of bacillus proteus was positive in 6 cases (18.75%). Among 32 cases, 24 cases were misdiagnosed in the first visiting clinic. The misdiagnosis rate of the initial diagnosis of this disease reached as high as 75%. Azithromycin was effective. The curative rate was 96.88% and the mortality was 3.13% (1 case).


CONCLUSIONS
Clinical characteristics of tsutsugamushi disease are complicated, and it is commonly complicated with liver damages. The Weil-Felix test is not very important to initial diagnosis for tsutsugamushi disease in local. For patients as fever with unknown origin (FUO) and with the liver damage, the diagnosis of tsutsugamushi disease should be reminded.
Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Suqian 223800, China.
Ming
M
Sun
Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Suqian 223800, China.
Dong-Liang
DL
Wang
Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Suqian 223800, China.
Chun-Yun
CY
Zhao
Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Suqian 223800, China.
Qiu-Xiang
QX
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy