恙虫病100例临床影像学分析

Clinical and Imaging Analysis of Scrub Typhus of 100 Cases

目的 探讨恙虫病的临床影像学资料 ,评价其诊断价值。材料与方法 回顾性分析 10 0例恙虫病的临床及影像学表现。结果 符合诊断标准的男 43例 ,女 5 7例 ,年龄 1.5～ 80岁 (平均 30岁 ) ,6～ 9月为发病高峰 ,多有野外作业史。常见症状为高热、皮肤焦痂和溃疡、皮疹、淋巴结肿大。实验室检查血细胞减少 ,血清外 菲氏OXk凝集反应阳性。影像学表现 :胸部异常占 38% ,以肺门阴影增大、肺纹理增多、小斑点状模糊影为常见 ,少数可有含液面空洞、胸腔积液及脑出血。结论 恙虫病诊断主要依靠临床、实验室及流行病学调查 ,影像诊断为非特异性的 。

Objective To analyze the clinical data and imaging findings in 100 cases with scrub typhus and to assess their diagnostic value.Materials and Methods One hundred cases of scrub typhus, including 43 males and 57 females, aged 1.5～80 years, were collected in this study. The clinical data and imaging findings were retrospectively analyzed.Results Morbidity peak of scrub typhus appeared in June to September. Most patients had a history of working in open field, and presented as high fever, skin eschars, ulcers or rashes and lymphadenopathy. Laboratory examination showed decreased peripheral blood count and positive serum OXK agglutination reaction. Abnormal chest imaging findings were seen in 38% patients, manifested as hilar enlargement, increased lung markings, obscured patchy or punctate shadows, and pleural effusion. Cerebral hemorrhage could be found.Conclusion The diagnosis of scrub typhus is mainly based on the clinical data, laboratory tests and epidemic investigation. Imaging findings are non specific, but helpful for evaluating complications. Imaging examination can be served as a necessary adjunctive diagnostic method.