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目的通过分析北京市平谷区2008年10月～11月爆发的恙虫病24例,总结提高非流行地区恙虫病诊断率的方法。方法对24例恙虫病患者的一般资料、临床表现、实验室检查、诊断和治疗进行全面分析。结果24例患者中均有高热和皮疹,部分患者有焦痂或溃疡、淋巴结肿大,头痛、头晕等神经系统症状,在发病1周内,外-斐氏反应OXk阳性者仅有4例,14例经卫生部临床检验中心PCR检测确诊为恙虫病。结论恙虫病在以往非流行地区也可出现爆发流行,细致查体,有目的地重复化验有助于早期诊断。
Objective To analyze 24 cases of tsutsugamushi disease in Pinggu District of Beijing from October to November, 2008 and summarize the methods to improve the diagnosis rate of tsutsugamushi disease in non-endemic areas. Methods A total of 24 cases of tsutsugamushi disease in patients with general information, clinical manifestations, laboratory tests, diagnosis and treatment of a comprehensive analysis. Results All 24 patients had hyperthermia and rash. Some patients had estrogen-like symptoms such as eschar, ulcer, lymphadenopathy, headache, and dizziness. Only 1 out of 4 patients were found to have OX-positive reaction after 1 week of onset, 14 cases were diagnosed as tsutsugamushi by PCR test by clinical testing center of Ministry of Health. Conclusion Epidemics of tsutsugamushi in the past non-endemic areas may also occur outbreaks, detailed examination, purposeful duplication of tests will help early diagnosis.