Epidemiological and clinical characteristics of 155 patients with tsutsugamushi disease in Guangdong Province from 2016 to 2021 / 中华地方病学杂志

ABSTRACT

Objective:To analyze the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Guangdong Province from 2016 to 2021, and to provide a reference for clinical diagnosis, treatment, scientific prevention and control of tsutsugamushi disease.Methods:A retrospective analysis was conducted to collect the information of patients with tsutsugamushi disease admitted to Guangzhou Eighth Hospital Affiliated to Guangzhou Medical University from 2016 to 2021, including the basic information, epidemiological characteristics, clinical manifestations, auxiliary examinations, complications, misdiagnosis at first diagnosis and treatment outcomes.Results:Among 155 patients with tsutsugamushi disease, there were 75 males (48.39%) and 80 females (51.61%), with an e age of (54.41 ± 13.78) years old, and 30 cases (19.35%) had other underlying diseases. The peak time of onset was from June to September. There were 97 local patients (62.58%) in Guangzhou, and 58 cases (37.42%) in other prefecture-level cities; 76.77% (119/155) had a history of field activities before the onset of the disease. 36.13% (56/155) were farmers. The most common clinical manifestations were fever (100.00%, 155/155), chills and/or shivering (77.42%, 120/155), headache and/or dizziness (74.19%, 115/155), fatigue (65.81%, 102/155), eschar or ulcer (92.90%, 144/155), and lymphadenopathy (49.68%, 77/155). The laboratory test results mainly showed a decrease in eosinophils (81.94%, 127/155), a decrease in hematocrit (78.71%, 122/155), a decrease in hemoglobin (52.26%, 81/155), a decrease in platelet count (50.97%, 79/155), a decrease in albumin (92.26%, 143/155), an increase in lactate dehydrogenase (90.32%, 140/155), an increase in adenosine deaminase (88.39%, 137/155), and an increase in alanine aminotransferase (85.16%, 132/155), elevated aspartate aminotransferase (85.16%, 132/155), and elevated procalcitonin (52.90%, 82/155); 30 cases (19.35%) were positive for the Weil-Felix Test. There were 95 cases (61.29%) with abnormal chest imaging results, and 34 cases (21.94%) with abnormal abdominal ultrasound or CT results. Common complications were toxic hepatitis, pulmonary infection, organ failure, and acute kidney injury, etc. The misdiagnosis rate of the initial diagnosis of this disease was 75.48% (117/155). Doxycycline and symptomatic and supportive therapy were given, 154 patients (99.35%) were cured or improved and discharged from hospital.Conclusions:Tsutsugamushi disease is prevalent in summer and autumn in Guangdong Province. Before the onset, most of the patients have a history of field activities. Farmers are susceptible people. Its clinical manifestations are diverse, and can affect multiple systems and organs. There are many complications, and doxycycline can be used for anti-infection treatment, with a high cure rate.