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題名 | 恙蟲病的皮膚表現=Cutaneous Manifestations of Scrub Typhus |
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作者 | 吳育弘; 蘇信義; | 書刊名 | 中華皮膚科醫學雜誌 |
卷期 | 16:4 1998.12[民87.12] |
頁次 | 頁251-260 |
分類號 | 415.26 |
關鍵詞 | 恙蟲病; 皮膚; Scrub typhus; Tsutsugamushi disease; Rickettsia tsutsugamushi; Eschar; |
語文 | 中文(Chinese) |
中文摘要 | 恙蟲病由恙蟲病立克次體所引起,為花東地區常見的傳染病,本院臺東分院近年來 每年約有 20 至 30 例確定病例的報告。 本文針對本院自 1992 年 1 月至 1997 年 12 月 的 111 例確定病例作一臨床分析。 臨床表現以發燒 (100%)、肝功能異常 (93.3%)、 焦痂 (64.9%)、淋巴腺腫大 (53.2%)、頭痛 (47.7%)、腹痛 (45.0%)、 咳嗽 (36.0%)、皮膚紅疹 (36.0%)、結膜炎 (12.6%) ...等為主。在皮膚表現中出現焦痂者有72人(64.9%),焦痂出 現最多的位置依序為腹部 12 人 (16.7%)、腹股溝 11 人 (15.3%)、腋下 9 人 (12.5%) 及 陰囊 7 人 (9.7%)。出現皮膚紅疹者有40 人 (36.0%),皮疹的表現則以全身性紅色斑點丘疹 13 人 (32.5%) 為最多,其次為全身性或瀰漫性紅斑 8 人 (20.0%),及散在性紅色斑點丘 疹 6 人 (15.0%) 三類為主。 所有患者中有 13 人 (11.7%) 是皮膚科醫師經由門診、急診 或會診而診斷出來的。因此對於在流行區內的皮膚科醫師來說,是必須列入鑑別診斷的重要 疾病。 |
英文摘要 | Scrub typhus (Tsutsugamushi disease) is an endemic infectious disease in eastern area of Taiwan caused by Rickettsia tsutsugamushi. One hundred and eleven cases were diagnosed and confirmed by indirect immunofluoresence method in our hospital (Taitung branch) from Jan. 1992 to Dec. 1997. The clinical features included fever (100%), impaired liver function tests (93.3%). eschar (64.9%), lymphadenopathy (53.2%), headache (47.7%), abdominal pain (45.0%), cough(36.0%), skin rashes (36.0%), conjunctivitis (12.6%)...etc. The cutaneous manifestations were analyzed by chart record; the photographs and the samples of skin biopsy were evaluated by dermatologists. Eschar were found in 72 cases (64.9%) and the most common sites were abdomen (12 cases, 16.7%), groin area (11 cases, 15.3%), axilla (9 cases, 12.5%) and scrotum (7 cases, 9.7%). The skin rashes could be found in 40 cases (36.0%) and were classified into several types. The most common three types were generalized erythematous maculopapules (13 cases, 32.5%), generalized erythematous maculopatches or diffuse erythema (8 cases, 20.0%) and scattered erythematous maculopapules (6 cases, 15.0%) . Thirteen cases (11.7%) were diagnosed by dermatologists in these years. Scrub typhus is such an important disease in the differential diagnosis of fever with rashes in the endemic area that the physicians should keep in mind. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。