海南医科大学学报

目的:分析恙虫病合并肺部损伤的临床特点。方法:回顾性分析2006年7月~2010年10月治疗的25例恙虫病合并肺部损伤的临床资料。结果:所有25例患者会出现发热、焦痂或溃疡、淋巴结肿大、皮疹以及周围血液白细胞减少等恙虫病等症状,同时伴有咳嗽、咳痰、咯血、呼吸困难、肺部啰音、胸部X线损害表现和(或)胸腔积液等肺部症状,极易误诊为肺部疾病,误诊率为36%。24例治愈,仅有1例死于多器官衰竭及成人呼吸窘迫综合征(ARDS)。结论:恙虫病合并肺部损伤的临床表现比较复杂,误诊率高,应引起重视。早期诊断和及时治疗,是治疗恙虫病合并肺部损伤的关键。

Objective: To analyze the clinical features of tsutsugamushi disease complicated with pulmonary injury.Methods: The clinical data of 25 cases with tsutsugamushi disease complicated by pulmonary injury who were admitted from July 2006 to October 2010 were analyzed retrospectively.Results: All patients developed fever,eschar or ulcers,swollen lymph nodes,rash,reduction of leukocytes in peripheral blood and other symptoms.Besides,they also had pulmonary symptoms such as cough,expectoration,hemoptysis,dyspnea,pulmonary rales,damage manifestation in chest X ray and(or) pleural effusion,which were easily misdiagnosed as lung disease.And the misdiagnosis rate was 36%.After treatment,24 cases were cured,while only one case died of multiple organ failure and adult respiratory distress syndrome.Conclusions: The manifestation of tsutsugamushi disease complicated with pulmonary injury is complicated,and misdiagnosis rate is high.More attention should be paid on the diagnosis.Early diagnosis and treatment in time are key to treat tsutsugamushi disease complicated with pulmonary injury.