严重日本斑疹热的临床特征和风险因素:日本西部长崎县的一项回顾性多中心研究。

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Kohsuke Matsui, Shingo Masuda, Yosuke Koizumi, Monami Yamanaka, Yasumori Izumi, Chris Smith, Reiko Miyahara, Koya Ariyoshi
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引用次数: 0

摘要

日本斑疹热(JSF)是一种流行于日本西部的蜱传立克次体疾病,发病率和地理分布都在不断增加。这项回顾性研究旨在描述日本斑疹热的临床特征,并确定与其严重形式相关的因素。我们纳入了 2010 年至 2021 年长崎县实验室确诊的 JSF 成年患者。出现精神状态改变、低血压或低血氧饱和度即为重症 JSF。共诊断出 65 例 JSF。常见症状为发热(87%)、皮疹(48%)和乏力(48%),其中有 50 名患者(79.4%)检测到疱疹。38名患者(60.3%)最初被诊断为非 JSF 病症。21例(33.3%)被归类为严重JSF,其中1例死亡。与重症 JSF 相关的院前因素包括年龄≥75 岁(调整赔率比 [aOR]37.53,95% 置信区间 [CI]3.03-465.38)、性别为男性(aOR 26.5,95% CI 4.23-166.00)和发病后治疗延迟≥4 天(aOR 5.96,95% CI 1.13-31.60)。由于JSF的临床表现无器官特异性,这项研究凸显了JSF在诊断方面的挑战。延迟初始治疗、高龄和男性显著增加了病情严重的风险。进一步提高流行地区临床医生和居民对 JSF 的认识至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Characteristics and Risk Factors for Severe Japanese Spotted Fever: A Retrospective Multicenter Study in Nagasaki Prefecture, Western Japan.

Japanese spotted fever (JSF) is a tick-borne rickettsial disease prevalent in western Japan, with an increasing incidence and geographical distribution. This retrospective study aimed to describe the clinical features of JSF and identify factors associated with its severe form. We included adult patients with laboratory confirmed JSF in Nagasaki prefecture from 2010 to 2021. Severe JSF was defined by the presence of altered mental status, low blood pressure, or low oxygen saturation. In total, 65 JSF cases were diagnosed. Common symptoms were fever (87%), rash (48%), and fatigue (48%) with eschars detected in 50 (79.4%) of patients. Thirty-eight (60.3%) patients were initially diagnosed with non-JSF conditions. Twenty-one (33.3%) cases were categorized as severe JSF, including one death. Pre-hospital factors associated with severe JSF included age ≥75 (adjusted odds ratio [aOR] 37.53, 95% confidence interval [CI] 3.03-465.38), male sex (aOR 26.5, 95% CI 4.23-166.00), and a treatment delay ≥4 days from onset (aOR 5.96, 95% CI 1.13-31.60). This study highlights diagnostic challenges of JSF due to its non-organ-specific clinical presentation. Delayed initial treatment, advanced age, and male sex significantly increase the risk of severity. It is crucial to further raise awareness of JSF among clinicians and residents in endemic areas.

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来源期刊
CiteScore
4.50
自引率
4.50%
发文量
172
审稿时长
2 months
期刊介绍: Japanese Journal of Infectious Diseases (JJID), an official bimonthly publication of National Institute of Infectious Diseases, Japan, publishes papers dealing with basic research on infectious diseases relevant to humans in the fields of bacteriology, virology, mycology, parasitology, medical entomology, vaccinology, and toxinology. Pathology, immunology, biochemistry, and blood safety related to microbial pathogens are among the fields covered. Sections include: original papers, short communications, epidemiological reports, methods, laboratory and epidemiology communications, letters to the editor, and reviews.
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