Epidemiological and clinical characteristics of 93 patients with tsutsugamushi disease in Hainan Province / 中华地方病学杂志

ABSTRACT

Objective:To analyze the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Hainan Province, so as to provide basis for diagnosis, treatment, prevention and control of the disease.Methods:Clinical data of 93 patients with tsutsugamushi disease in the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2019 were collected. Epidemiological data, clinical manifestations, examination results, treatment and outcome of the patients were retrospectively analyzed.Results:Of totally 93 patients with tsutsugamushi disease, 48 were male and 45 were female, with an average age of 50.73 years old. The peak time of onset was from June to October, with 46 cases (49.46%). Seventy cases (75.27%) were farmers, and 84 cases (90.32%) had a clear history of field work or grassland contact before onset. The clinical manifestations were fever (93/93, 100.00%), eschar or ulcer (42/93, 45.16%), headache (65/93, 69.89%), chills (60/93, 64.52%), rash (35/93, 37.63%), lymphadenopathy (51/93, 54.84%) and fatigue (40/93, 43.01%). Laboratory examination results: eosinophil reduced (74/93, 79.57%), platelet reduced (32/93, 34.41%); alanine aminotransferase, C reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) were increased in 81.72% (76/93), 97.85% (91/93), 20.43% (19/93) and 72.04% (67/93) of the patients, respectively. Eighty-four cases (90.32%) had abnormal results of chest imaging. All patients were cured by doxycycline.Conclusions:Tsutsugamushi disease is prevalent in summer and autumn in Hainan. It has various clinical manifestations. Doxycycline is an effective treatment drug. It is suggested that the relevant departments should strengthen the training of clinical diagnosis and treatment of tsutsugamushi disease by local clinicians to reduce the misdiagnosis rate.