Clinical Medicine
Clinical features of 59 patients with scrub typhus in Kunming City
Qin Peng, Wu Li, Yanghong Zou, Shenjun Zhao, Xiuling Zhang, Chunyan Mou, Jiangyan Zhang
Published 2018-08-20
Cite as Chin J Endemiol, 2018, 37(8): 664-667. DOI: 10.3760/cma.j.issn.2095-4255.2018.08.015
Abstract
ObjectiveTo study the clinical features of patients with scrub typhus and provide scientific basis for clinical diagnosis and treatment.
MethodsClinical data of patients with scrub typhus in the First Affiliated Hospital of Kunming Medical University from January 2016 to December 2016 were collected. Epidemiological data, clinical manifestations, laboratory findings, image examination results, treatment and outcome were retrospectively analyzed.
ResultsThe clinical manifestations included 59 cases (100.0%) with fever, 44 cases (74.6%) with headache, 39 cases (66.1%) with chills, 34 cases (57.6%) with muscle and joint pain, 29 cases (49.2%) with prostration, 49 cases (83.1%) with eschar or ulcer, 42 cases (71.2%) with lymphadenectasis, 23 cases (39.0%) with hepatosplenomegaly. Laboratory test results: 51 cases (86.4%) had normal or elevated white blood cell count, 50 cases of eosinophil reduced (84.7%), 27 cases of blood platelet (PLT) reduced (45.8%), 33 cases of albumin reduced (55.9%), 50 cases of alanine aminotransferase (ALT) increased (84.7%), 48 cases of aspartate aminotransferase (AST) increased (81.4%), and 56.1% (23/41) of the patients with triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free thyroxine (FT4) levels significantly lowered, with predominantly free FT3 reduction (82.6%,19/23); C reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and ferritin were increased in 93.9% (46/49), 35.4% (17/48), 64.9% (24/37), and 83.8% (31/37) of the patients, and 95.6% (43/45) was accompanied with chest radiographic abnormalities. Tetracycline, doxycycline and azithromycin treatment were all effective.
ConclusionsThe clinical manifestations of patients with scrub typhus, involving multisystem, are diverse and thyroid hormones decrease is observed. Early diagnosis and treatment is the key to improve the prognosis of patients with scrub typhus.
Key words:
Scrub typhus; Thyroid hormones; Clinical features
Contributor Information
Qin Peng
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Wu Li
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Yanghong Zou
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Shenjun Zhao
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Xiuling Zhang
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Chunyan Mou
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
Jiangyan Zhang
Department of Infectious Diseases, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China