"There is a risk of tsutsugamushi disease infection in the lawn, and the peak of infection is in summer and autumn." Director Zou Minchao of the Department of Infectious Diseases of the Second Municipal Hospital said that tsutsugamushi disease is an acute infectious disease with chigger mites (larvae of chigger mites) parasitic in weeds as the transmission medium. "Chigger mites like to parasitize wild animals, especially rats. Therefore, rodents are an important source of infection. " Regarding the harm of tsutsugamushi disease, Zou Minchao said that if the treatment is delayed, due to the rapid development of tsutsugamushi disease, myocarditis, pleurisy, encephalitis, multiple organ failure and even death may soon occur. However, not everyone bitten by chigger mites will get tsutsugamushi disease, and there are two conditions to get sick: first, rickettsia tsutsugamushi (a microorganism) exists in chigger mites that bite people; Second, the resistance of the bitten person is weak. If these two conditions are met, after the incubation period of 4 ~ 21day, the bitten person will have a fever, and his body temperature will continue to be around 39 ~ 40 degrees Celsius.
Tsutsugamushi disease, also known as scrub typhus, is caused by chigger mites.
Natural focus diseases caused by rickettsia. The clinical features are sudden onset, fever, eschar or ulcer at the bite, swollen lymph nodes and rash. As early as 3 13 A.D., Ge Hong, a medical scientist in the Jin Dynasty in China, once described that "when a person walks through grass and sand and is bitten by a red tiny sand louse, a rash occurs, and after three days, he will get fever and bite local ulcers and scabs", which is quite similar to modern tsutsugamushi disease. But it was not until 1948 that rickettsia tsutsugamushi was separated from Guangzhou. The disease was first described by Japanese in 18 10. In 1927, Japanese scholar Ogata and others injected the patient's blood into the testis of rabbits. After 5-6 passages, the scrotum became red and swollen, and rickettsia was found by smear staining, named Rickettsia orteintalis. 193 1 year was named Rickettsia tsutsugamushi.
Tsutsugamushi disease, also known as jungle typhus, is an acute infectious disease caused by rickettsia tsutsugamushi (also known as Rickettsia orientalis). Its basic pathological changes are systemic vasculitis, perivascular inflammation and reticuloendothelial cell proliferation. Clinically, it is characterized by fever, eschar (or ulcer), lymphadenopathy, rash and hepatosplenomegaly. This disease is a natural focus infectious disease, and the incidence rate is high in the coastal islands in the southeast and southwest of China. Rodents are the main source of infection, which is transmitted to people through bites.
clinical picture
1. Acute onset, chills or chills, high fever, body aches, fatigue, anorexia and other acute infection symptoms. 2. Facial flushing, conjunctival congestion, eschar or ulcer, lymphadenopathy, rash, hepatosplenomegaly, etc. 3. In the second week of the course of the disease, the disease often gets worse, including apathy, hard of hearing, delirium, even convulsion or coma, meningeal irritation or myocarditis, or pneumonia symptoms such as cough, chest pain and shortness of breath.
Diagnostic basis
1. epidemiological data: there was a history of field contact with rodents or the breeding environment of scrub typhus within 3 weeks before the onset of the disease. 2. Clinical manifestations: sudden chills, persistent high fever, conjunctival congestion, rash, lymphadenopathy, especially obvious swelling and tenderness of local lymph nodes, hepatosplenomegaly. The eschar or ulcer on the body surface skin is the most valuable specific sign for diagnosis. 3. Laboratory examination: white blood cells are normal or decreased, the classification moves to the left, and platelets may decrease. Weil felix reaction serum titer OXK> = 1: 160 positive has important reference value. Positive complement fixation test, indirect immunofluorescence test, double serum titer increased by more than 4 times or single serum titer reached1:800, or mice were inoculated in abdominal cavity and isolated from rickettsia tsutsugamushi.
Principles of treatment
1. General treatment: bed rest, semi-fluid, antipyretic and analgesic if necessary, adrenocortical hormone for severe patients or those complicated with myocarditis and meningitis. 2. Pathogen treatment: chloramphenicol and tetracycline family have special effects on this disease.
Medication principle
1. Chloramphenicol can be taken orally for the early treatment of tsutsugamushi disease, and doxycycline can be used if there is drug resistance. 2. For severe tsutsugamushi disease, chloramphenicol can be used intravenously, and dexamethasone can be added. If there is drug resistance, erythromycin or baimycin can be used instead, and fluoroquinolones can also be tried.
accessory examination
1. "A" is the main examination item for tsutsugamushi disease with typical clinical manifestations. 2. For those whose clinical manifestations are atypical, especially the special sign of eschar can not be found, the examination items may include examination limits "a" and "b". 3. When there are neurological complications and it is difficult to distinguish them from other neurological diseases, the examination items may include "A", "B" and "C". Curative effect evaluation and cure: clinical symptoms subsided, the course of treatment was completed, and there was no recurrence after drug withdrawal. Ineffective: fever persists and symptoms are not improved.
Edit this paragraph of expert reminder
The first symptom of tsutsugamushi disease, which is easy to be misdiagnosed, is high fever, which is easy to be considered as a cold and neglected by patients.
Depending on or delaying treatment. However, the bite site of chigger larvae is hidden, eschar (or ulcer) is difficult to find, and when the patient's medical history is unclear, it is easy to be misdiagnosed. Therefore, if citizens have high fever for a long time after outdoor activities, and eschar is found in waist, armpit and groin, they should be alert to whether they are suffering from tsutsugamushi disease and seek medical advice as soon as possible. At the same time, remind the public to remember to wear mosquito repellent when visiting the park in summer and autumn, and wear clothes with sleeves that can seal the sleeves and neckline. Try not to enter the grass, and don't sit on the grass or touch crops at will. "Daily homes should be kept clean to avoid sanitary corners. Ying Qin, a citizen who likes to plant flowers and plants, weeding, killing insects and rodents, and spraying pesticides where rats come in and out." Expert: Preventable and treatable, there is no need to panic. Professor Wu from the Entomology Department of South China Agricultural University has long been engaged in the research of agricultural insects and agricultural mites. He introduced that there are many kinds of active insects in the Pearl River Delta region, and those that may affect and harm human bodies can be roughly divided into four categories: Coccidae, Anthuridae, Chigger Mites, Acari Acari 1 suborder (commonly known as ticks). Professor Wu pointed out that insects are "quiet" during the high and low temperatures of the year. "But now it has gradually entered a relatively cool autumn, which is a period of high incidence of all kinds of pests. It is necessary for everyone to take precautions. For example, keep indoor sanitation and ventilation, and carry mosquito-repellent water when going out. " Professor Wu also pointed out that after many insects come into contact with the human body or bite the human body, they will cause some people's skin allergies, redness and other adverse reactions. "But as long as they are found, they can be cured in time, and most of them are non-infectious. The public need not worry too much to avoid causing tension.