摘要
消化系统是恙虫病东方体(Ot)感染最主要的靶器官,其损害是恙虫病“高热、焦痂、皮疹三联征”之外最常见的临床表现。消化系统涉及食管、胃、十二指肠、肝脏、胆囊及胆道、胰腺、小肠、结肠等,既有实性器官肝脏、胰腺等,也有腔道器官食管、胃、肠等。感染导致实性器官炎症、肿大、渗出等,导致腔道器官炎症、溃疡、出血、穿孔等急危重症。如果病因诊断和病因治疗延迟,可能导致多器官功能衰竭等严重病症。紧抓恙虫病“高热、焦痂、皮疹三联征”、野外作业史、嗜酸性粒细胞(EOS)计数下降等Ot感染线索,开展Ot病原学检查、实验室检查、影像学检查,应用“恙虫病积分诊断量表”,是准确诊断的关键。
The digestive system is a major target Orientia tsutsugamushi(Ot)infection.Its damage is the most frequent clinical manifestation of scrub typhus aside from the classic"triad of high fever,eschar and rash".The digestive system comprises the esophagus,stomach,duodenum,liver,gallbladder,biliary tract,pancreas,small intestine,colon,and rectum,including both solid organs(e.g.,liver and pancreas)and hollow organs(e.g.,esophagus,stomach,and intestines).Ot infection induces inflammation,swelling and exudation in solid organs,while causing inflammation,ulceration,bleeding,perforation,and other critical conditions in hollow organs.Delayed etiological diagnosis and treatment may result in severe complications like multiple organ failure.Accurate diagnosis hinges on recognizing Ot infection clues,such as scrub typhus'"triad of high fever,eschar,and rash",outdoor exposure history,and reduced eosinophil count.It also involves conducting Ot etiological tests,laboratory tests,imaging studies,and applying the"scrub typhus diagnostic scoring scale".
作者
李凤霞
刘康霄
刘鑫华
毛静
钟炎平
杨军杰
李姗
刘园园
雷旭
李健
谭华炳
LI Fengxia;LIU Kangxiao;LIU Xinhua;MAO Jing;ZHONG Yanping;YANG Junjie;LI Shan;LIU Yuanyuan;LEI Xu;LI Jian;TAN Huabing(Department of Infectious Diseases,Renmin Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China;Departmemnt of Paediatrics,Fang County Renmin Hospital,Shiyan,Hubei 442100,China;Department of Respiratory Medicine,Wuchang Hospital Affiliated to Wuhan University of Science and Technology,Wuhan,Hubei 430060,China;Department of Cardiology,Heyuan People's Hospital,Heyuan,Guangdong 517001,China;Department of Respiratory Diseases,Guoyao Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China;Department of Infectious Diseases,Suizhou Hospital,Hubei University of Medicine,Suizhou,Hubei 441399,China;Shiyan Key Laboratory of Virology,Hubei University of Medicine,Shiyan,Hubei 442000,China;Department of General Internal Medicine,Wuhan Jinyintan Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei 430023,China)
出处
《安徽医药》
2025年第6期1061-1064,共4页
Anhui Medical and Pharmaceutical Journal
基金
国家自然科学基金青年科学基金项目(81802046)。
关键词
恙虫病
消化系统
肝胆脾
胃肠道
胰腺
皮疹
嗜酸性粒细胞
诊断
Tsutsugamushi disease
Digestive system
Hepatobiliary spleen
Gastrointestinal tract
Pancreas
Rash
Eosinophils
Diagnosis
