恙虫病并肺部合并症40例临床分析

A clinical analysis of 40 cases of pulmonary complications associated with tsutsugamushi disease

目的研究40例恙虫病肺部合并症的临床特点。方法分析40例恙虫病并肺部合并症的患者症状和体征、X线胸片、胸部CT。结果临床表现高热有36例(90%),有焦痂或溃疡40例(100%),淋巴结肿大24例(60%),皮疹18例(45%),咳嗽咳痰38例(95%),肺部啰音34例(85%),X线胸片:肺部炎性渗出性病变40例(100%),CT肺实质病变40例(100%),肺间质炎性改变16例(40%),胸膜病变10例(25%),胸腔积液8例(20%)。结论恙虫病肺部合并症临床表现不典型,影像学表现易误诊,应重视病史及寻找焦痂的体检。

Objective To discuss the clinical feature of pulmonary complications associated with tsutsug-amushi disease. Methods 40 patients who had pulmonary complications associated with tsutsug-amushi disease were retrospectively analyzed by signs and symptoms, chest radiographs, chest CT. Results Of them 36 cases （90%） had high fever, 40 cases （ 100% ） had eschar or ulcer, 38 cases （95%） had cough and sputum,34 cases （85%） had rales. Chest X-rays：40 cases （ 100% ） showed pulmonary inflammatory effusion lesion, chest CT ：40 cases （ 100% ） showed pulmonary parenchymal lesions, 16 cases （40%） showed pulmonary interstitial lesions, 10 cases （25%） showed disease of pleura,8 cases （20%） showed pleural effusion. Conclusion The clinical maniplications associated with tsutsugamushi disease are multiplicity, iconography misdiagnosis rate are high. We should pay more attention to medical history and eschar.