三级医院恙虫病患者临床特点及治疗模式研究

Shubham Ingle, Atul Rajkondwar
{"title":"三级医院恙虫病患者临床特点及治疗模式研究","authors":"Shubham Ingle, Atul Rajkondwar","doi":"10.25259/vjim_12_2021","DOIUrl":null,"url":null,"abstract":"\n\nTo assess the clinical features, complications and treatment of scrub typhus patients in tertiary care hospital.\n\n\n\nA total of 100 patients with scrub typhus, aged >12 years admitted in medicine wards and intensive care units of Government Medical College, Nagpur, were included in the study. A detailed history was taken; clinical examination, all relevant investigations, and IgM ELISA test were done for the diagnosis of scrub typhus.\n\n\n\nThe most common presenting symptoms were high-grade fever with chills (80%). The most common complication was lung involvement (35%), liver damage (28%), and acute kidney injury (27%) with six cases requiring renal replacement therapy. Multisystem organ dysfunction syndrome was seen in 19% of cases. About 27% of patients had acute respiratory distress syndrome of which 16 cases needed mechanical ventilation. Of 100 patients included, 82 (82%) cases survived and were discharged, while 18 (18%) patients succumbed during hospital admission. Among the risk factor studied, systemic hypertension was associated with an increase in mortality (P = 0.014). There was a statistically significant increase in mortality (P = 0.006) in patients having electrocardiogram abnormalities in the forms of low-voltage complexes and tachycardia. Early diagnosis and rapid treatment with doxycycline (93.90%) and ceftriaxone (87.80%) were found to be associated with more survival rate.\n\n\n\nScrub typhus is a significant disease in this part of the country; therefore, it should be kept in mind as a possible diagnosis in undifferentiated fevers even though an eschar is not found. An early diagnosis and timely antibiotic therapy may prevent further complications.\n","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Study of Clinical Profile and Treatment Pattern of Scrub Typhus Patients in Tertiary Care Hospital\",\"authors\":\"Shubham Ingle, Atul Rajkondwar\",\"doi\":\"10.25259/vjim_12_2021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n\\nTo assess the clinical features, complications and treatment of scrub typhus patients in tertiary care hospital.\\n\\n\\n\\nA total of 100 patients with scrub typhus, aged >12 years admitted in medicine wards and intensive care units of Government Medical College, Nagpur, were included in the study. A detailed history was taken; clinical examination, all relevant investigations, and IgM ELISA test were done for the diagnosis of scrub typhus.\\n\\n\\n\\nThe most common presenting symptoms were high-grade fever with chills (80%). The most common complication was lung involvement (35%), liver damage (28%), and acute kidney injury (27%) with six cases requiring renal replacement therapy. Multisystem organ dysfunction syndrome was seen in 19% of cases. About 27% of patients had acute respiratory distress syndrome of which 16 cases needed mechanical ventilation. Of 100 patients included, 82 (82%) cases survived and were discharged, while 18 (18%) patients succumbed during hospital admission. Among the risk factor studied, systemic hypertension was associated with an increase in mortality (P = 0.014). There was a statistically significant increase in mortality (P = 0.006) in patients having electrocardiogram abnormalities in the forms of low-voltage complexes and tachycardia. Early diagnosis and rapid treatment with doxycycline (93.90%) and ceftriaxone (87.80%) were found to be associated with more survival rate.\\n\\n\\n\\nScrub typhus is a significant disease in this part of the country; therefore, it should be kept in mind as a possible diagnosis in undifferentiated fevers even though an eschar is not found. An early diagnosis and timely antibiotic therapy may prevent further complications.\\n\",\"PeriodicalId\":232453,\"journal\":{\"name\":\"Vidarbha Journal of Internal Medicine\",\"volume\":\"2 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vidarbha Journal of Internal Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.25259/vjim_12_2021\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vidarbha Journal of Internal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.25259/vjim_12_2021","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的探讨三级医院恙虫病的临床特点、并发症及治疗方法。研究对象为那格浦尔政府医学院内科病房和重症监护病房收治的100例恙虫病患者,年龄在1 ~ 12岁之间。记录了详细的历史;临床检查、各项相关调查及IgM酶联免疫吸附试验诊断恙虫病。最常见的症状是高热伴寒战(80%)。最常见的并发症是肺受累(35%)、肝损害(28%)和急性肾损伤(27%),其中6例需要肾脏替代治疗。多系统脏器功能障碍综合征占19%。约27%的患者出现急性呼吸窘迫综合征,其中16例需要机械通气。在纳入的100例患者中,82例(82%)存活并出院,18例(18%)患者在住院期间死亡。在研究的危险因素中,全身性高血压与死亡率增加相关(P = 0.014)。以低压复诊和心动过速形式出现心电图异常的患者死亡率有统计学意义上的显著增加(P = 0.006)。早期诊断和快速治疗多用西环素(93.90%)和头孢曲松(87.80%)可提高生存率。丛林斑疹伤寒是该国这一地区的一种重要疾病;因此,即使没有发现焦痂,也应将其作为未分化发热的可能诊断。早期诊断和及时的抗生素治疗可以预防进一步的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study of Clinical Profile and Treatment Pattern of Scrub Typhus Patients in Tertiary Care Hospital
To assess the clinical features, complications and treatment of scrub typhus patients in tertiary care hospital. A total of 100 patients with scrub typhus, aged >12 years admitted in medicine wards and intensive care units of Government Medical College, Nagpur, were included in the study. A detailed history was taken; clinical examination, all relevant investigations, and IgM ELISA test were done for the diagnosis of scrub typhus. The most common presenting symptoms were high-grade fever with chills (80%). The most common complication was lung involvement (35%), liver damage (28%), and acute kidney injury (27%) with six cases requiring renal replacement therapy. Multisystem organ dysfunction syndrome was seen in 19% of cases. About 27% of patients had acute respiratory distress syndrome of which 16 cases needed mechanical ventilation. Of 100 patients included, 82 (82%) cases survived and were discharged, while 18 (18%) patients succumbed during hospital admission. Among the risk factor studied, systemic hypertension was associated with an increase in mortality (P = 0.014). There was a statistically significant increase in mortality (P = 0.006) in patients having electrocardiogram abnormalities in the forms of low-voltage complexes and tachycardia. Early diagnosis and rapid treatment with doxycycline (93.90%) and ceftriaxone (87.80%) were found to be associated with more survival rate. Scrub typhus is a significant disease in this part of the country; therefore, it should be kept in mind as a possible diagnosis in undifferentiated fevers even though an eschar is not found. An early diagnosis and timely antibiotic therapy may prevent further complications.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信