Epidemiological and clinical characteristics of 93 patients with tsutsugamushi disease in Hainan Province
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.cn231583-20200407-00074
   		
        
        	
        		- VernacularTitle:海南省93例恙虫病患者流行病学和临床特征分析
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Liyuan ZHANG
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Qiuping WU
			        		
			        		;
		        		
		        		
		        		
			        		Kunliang WU
			        		
			        		;
		        		
		        		
		        		
			        		Yuting ZHU
			        		
			        		;
		        		
		        		
		        		
			        		Feifei YIN
			        		
			        		;
		        		
		        		
		        		
			        		Yongguo DU
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 海南医学院第二附属医院热带病科,海口 570311
			        		
		        		
	        		
        		 
        	
        	
        	
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Endemiology
	            		
	            		 2020;39(9):687-691
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective:To analyze the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Hainan Province, so as to provide basis for diagnosis, treatment, prevention and control of the disease.Methods:Clinical data of 93 patients with tsutsugamushi disease in the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2019 were collected. Epidemiological data, clinical manifestations, examination results, treatment and outcome of the patients were retrospectively analyzed.Results:Of totally 93 patients with tsutsugamushi disease, 48 were male and 45 were female, with an average age of 50.73 years old. The peak time of onset was from June to October, with 46 cases (49.46%). Seventy cases (75.27%) were farmers, and 84 cases (90.32%) had a clear history of field work or grassland contact before onset. The clinical manifestations were fever (93/93, 100.00%), eschar or ulcer (42/93, 45.16%), headache (65/93, 69.89%), chills (60/93, 64.52%), rash (35/93, 37.63%), lymphadenopathy (51/93, 54.84%) and fatigue (40/93, 43.01%). Laboratory examination results: eosinophil reduced (74/93, 79.57%), platelet reduced (32/93, 34.41%); alanine aminotransferase, C reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) were increased in 81.72% (76/93), 97.85% (91/93), 20.43% (19/93) and 72.04% (67/93) of the patients, respectively. Eighty-four cases (90.32%) had abnormal results of chest imaging. All patients were cured by doxycycline.Conclusions:Tsutsugamushi disease is prevalent in summer and autumn in Hainan. It has various clinical manifestations. Doxycycline is an effective treatment drug. It is suggested that the relevant departments should strengthen the training of clinical diagnosis and treatment of tsutsugamushi disease by local clinicians to reduce the misdiagnosis rate.