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目的探讨恙虫病的诊治方法。方法对到云南普洱市人民医院急诊的恙虫病46例患者的资料进行分析。结果 46例均有发热,起病急骤在1d内达高峰者20例;起病稍缓27d为26例,体温多在39～40℃,典型特征表现为皮肤有焦病或溃疡,局部或全身淋巴结肿大,皮疹其临床表现最易误诊为急性上呼吸道感染、肺炎、伤寒等常见病。结论对急诊发热患者应详细询问病史、详细体检、尤其注意皮肤隐蔽、潮湿部位有无焦病或溃疡、淋巴结肿大和皮疹。
Objective To investigate the diagnosis and treatment of scrub typhus. Methods The data of 46 patients with tsutsugamushi disease in the emergency department of Pu’er People’s Hospital of Yunnan Province were analyzed. Results All of the 46 patients had fever, with sharp onset in 20 days, with 20 cases reaching the peak in 1d. The onset was slightly delayed in 27 days, with 26 cases in 39 days. The body temperature was mostly in the range of 39-40 ℃. The typical symptoms were focal or ulcerated skin, Lymphadenopathy, the most likely clinical manifestations of rash misdiagnosed as acute upper respiratory tract infection, pneumonia, typhoid and other common diseases. Conclusion Patients with fever should be asked in detail history, detailed physical examination, with particular attention to the skin hidden, humid spots with or without coke disease or ulcer, swollen lymph nodes and rash.